Perioperative Events of Laparoscopic Cholecystectomy in Patients with Hemoglobinopathies

Background: Hemoglobinopathies represent a prevalent category of inherited genetic disorders characterized by disruptions in the biosynthesis of one or more globin polypeptide chains constituting the hemoglobin molecule. While laparoscopic cholecystectomy is the established surgical intervention for symptomatic cholelithiasis in individuals with normal hemoglobin profiles, the safety and feasibility of this procedure in the context of underlying hemoglobinopathies remains a subject of ongoing investigation and clinical uncertainty. Aims: To assess the safety of laparoscopic cholecystectomy in patients with hemoglobinopathies and to characterize the spectrum of perioperative events encountered during the preoperative, intraoperative, and postoperative periods. Methods: This retrospective comparative study conducted over a period of 5 years, involved 31 hemoglobinopathic patients and 75 patients with normal hemoglobin variant. All underwent laparoscopic cholecystectomy and comparison done regarding perioperative events. Results: The overall complication rate was 56.5% in hemoglobinopathic patients and 21.6% in the other group and the difference was statistically significant (P- value ˂0.001). Vaso-occlusive crisis occurred in 2 patients (%), respiratory complications (atelectasis and bronchitis) in (9.7%), acute chest syndrome in (4.8%) and hemolysis in (4.8%). Conclusions: Laparoscopic cholecystectomy can be considered a safe surgical approach in well-prepared patients with hemoglobinopathies. However, this patient population exhibits a significantly elevated risk of disease-specific complications, notably acute chest syndrome, hemolysis, and vaso-occlusive crises. These findings underscore the necessity for specialized and multidisciplinary pre-, intra-, and postoperative management, involving the surgeon, physician, and anesthetist, to optimize outcomes in hemoglobinopathic patients undergoing laparoscopic cholecystectomy.