Laparoscopic management of complicated Meckel's diverticulum in children: a 10-year review

BACKGROUND: Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, is prone to develop complications in the pediatric population. The authors report their 10-year experience with the management of complicated Meckel's diverticulum in children using laparoscopy.

METHODS: A retrospective review of all complicated Meckel's diverticulum cases involving children from 1998 to 2007 was performed. The efficacy and safety of laparoscopy used to manage complicated Meckel's diverticulum were assessed.

RESULTS: Over a 10-year period, 20 children (17 boys and 3 girls) with a mean age of 5 years (range, 7 months to 13 years) were included in the study. Of the 20 children, 12 presented with gastrointestinal bleeding, 2 had intestinal obstruction, 3 had abdominal pain mimicking acute appendicitis, 2 had inguinal hernia, and 1 had intussusception. Diagnostic laparoscopy was performed for all the patients. Laparoscopically assisted transumbilical Meckel's diverticulectomy was performed successfully for 18 of the children. The operative time ranged from 50 to 190 min (mean, 115 min). All the children had an uneventful recovery except one, who experienced a postoperative wound infection. Ectopic gastric mucosa was found in 14 cases.

CONCLUSIONS: Diverse pediatric surgical conditions result from Meckel's diverticulum. Laparoscopy is a safe and effective method for the management of complicated Meckel's diverticulum.