Characteristics of pediatric patients with biliary lithiasis. Immediate post-operative evolution
Main Article Content
Keywords
Child, Gallstones, Cholelithiasis, Cholecystectomy
Abstract
Background: Biliary lithiasis is a disease that is rarely diagnosed in children; in Mexico, its prevalence is less than 1 %. Due to the scarcity of investigations addressing epidemiology and surgical outcomes in pediatric patients, our purpose was to establish the epidemiology and post-operative course in children with biliary lithiasis.
Methods: A descriptive, cross-sectional study was conducted. All patients with a diagnosis of biliary lithiasis treated over a 6-year period with complete data in their medical records were included.
Results: Thirty children with biliary lithiasis with a mean of 12.5 years of age were analyzed; 66.7 % were female and 63 % were older than 11 years. Etiology was idiopathic in 93 %. The most important symptoms were abdominal pain, nausea and vomiting (77 %). 100% of the patients were diagnosed with ultrasonography. Laparoscopic cholecystectomy was performed in 60 % of the cases and no differences were observed in terms of complications compared with open surgery. The advantage for laparoscopic cholecystectomy was a reduced fasting and hospitalization time.
Conclusions: Biliary lithiasis occurs more frequently in adolescent females, hemolytic causes are rare and in most cases no cause was identified. More epidemiological studies are needed in order to understand the natural history of the disease in children.
References
Harris PD, Chateau BI, Miquel JF. Litiasis biliar pediátrica en una población de alta prevalencia. Rev Chil Pediatr. 2007;78(5):511-8.
Ferrándiz-Morales CA, De la O-Cavanzos ME, Cura-Esquivel IA, Montes-Tapia FF, Zapata-Castilleja CA. Prevalencia de colecistolitiasis en pacientes pediátricos. Medicina Universitaria. 2008;10(38):22-8.
Wesdorp I, Bosman D, de Graaff A, Aronson D, van der Blij F, Taminiau J. Clinical presentations and predisposing factors of cholelithiasis and sludge in children. J Pediatr Gastroenterol Nutr. 2000;31(4):411-7.
Palasciano G, Portincasa P, Vinciguerra V, Velardi A, Tardi S, Baldassarre G, et al. Gallstone prevalence and gallbladder volume in children and adolescents: An epidemiological ultrasonographic survey and relationship to body mass index. Am J Gastroenterol. 1989;84(11):1378-82.
Nomura H, Kashiwagi S, Hayashi J, Kajiyama W, Ikematsu H, Noguchi A, et al. Prevalence of gallstone disease in a general population of Okinawa, Japan. Am J Epidemiol. 1988;128(3):598-605.
Ganesh R, Muralinath S, Sankarnarayanan VS, Sathiyasekaran M. Prevalence of cholelithiasis in children –a hospital-based observation. Indian J Gastroenterol. 2005;24(2):85.
Kaechele V, Wabitsch M, Thiere D, Kessler AL, Haenle MM, Mayer H, et al. Prevalence of gallbladder stone disease in obese children and adolescents: Influence of the degree of obesity, sex and pubertal development. J Pediatr Gastroenterol Nutr. 2008;42(1):66-70.
Schweizer P, Lenz MP, Kirschner HJ. Pathogenesis and symptomatology of cholelithiasis in childhood. Dig Surg. 2000;17(5):459-67.
Rief S, Sloven DG, Lebenthal E. Gallstones in children. Characterization by age, etiology, and outcome. Am J Dis Child. 1991;145(1):105-8.
Holcomb GW Jr, Holcomb GW 3rd. Cholelithiasis in infants, children and adolescents. Pediatric Rev. 1990;11(9):268-74.
Chan S, Currie J, Malik AI, Mahomed AA. Pediatric cholecystectomy: Shifting goalposts in the laparoscopic era. Surg Endosc. 2008;22(5):1392-5.
Gowda JD, Agarwal P, Bagdi R, Subramanian B, Kumar M, Ramasundaram M, et al. Laparoscopic cholecystectomy for cholelithiasis in children. J Indian Assoc Pediatr Surg. 2009;14(4):204-6.
Gupta SK, Gupta V. Cholecystitis and cholelithiasis in children. Indian J Pediatr. 1991;28(7):801-3.
Pokorny WJ, Saleem M, O’Gorman RB, McGill CW, Harberg FJ. Cholelithiasis and cholecystitis in childhood. Am J Surg. 1984;148(6):742-4.
Sarnaik S, Slovis T, Corbett D, Emami A, Whitten C. Incidence of cholelithiasis in sickle cell anemia using the ultrasonic grayscale technique. J Pediatr. 1980;96(1):1005-8.
Kaechele V, Wabitsch M, Thiere D, Kessler AL, Haenle MM, Mayer H, et al. Prevalence of gallbladder stone disease in obese children and adolescents: influence of the degree of obesity, sex and pubertal development. J Pediatr Gastroenterol Nutr. 2008;42(1):66-70.
Batrum RJ, Crow HC, Foote SR. Ultrasonic and radiographic cholecystography. N Engl J Med. 1977; 296(10):538-41.
Greenberg M, Kangarloo H, Cochran ST, Sample WF. The ultrasonographic diagnosis of cholecystitis and cholelithiasis in children. Radiology. 1980; 137(3):745-9.
Kratzer W, Mason RA, Kachele V. Prevalence of gallstones in sonographic surveys worldwide. J Clin Ultrasound. 1999;27(1):1-7.