Clinical Characteristics and Risk Factors for Symptomatic Pediatric Gallbladder Disease

Mehta, Seema; López, Mónica E.; Chumpitazi, Bruno P.; Mazziotti, Mark V.; Brandt, Mary L.; Fishman, Douglas S.

doi:10.1542/peds.2011-0579

Cited by 130 publications

(104 citation statements)

References 47 publications

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“…Boys and girls are equally affected in early childhood, but as in adults, most previous studies reported a female predominance in pediatric gallbladder disease starting from puberty (6,(16)(17)(18). In the study by Wesdrop et al (6), a female predominance was noted only after the age of 14 years.…”

Section: Discussionmentioning

confidence: 93%

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Gökçe

Yıldırım²,

Erdoğan³

2014

Turk J Gastroenterol

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Background/Aims: To evaluate children with gallstone in respect to demographic features, type of presentation, predisposing risk factors, laboratory features, complications, and outcome. Materials and Methods: Overall, 124 children with sonographically diagnosed gallstone were stratified into group 1 (symptomatic) and group 2 (asymptomatic). The data on demographic features, predisposing risk factors, laboratory features, complications, and outcome were collected from medical charts and compared by using convenient statistical methods.Results: There were 76 (61%) children in group 1. Females were significantly older than males at the time of diagnosis (p=0.001). After adjusting for age and sex, asymptomatic presentation was associated with hemolytic anemia (r=346, <0.001) and being an oncologic patient (r=248, p=0.006). No risk factor was specifically associated with having a symptomatic presentation. Sixteen children (12.9%) developed complications: 14 (18.4%) in group 1 and 2 (4.2%) in group 2 (p=0.027). Gallstone resolution was detected in 20 (29.4%) and 10 children (23.3%) in groups 1 and 2, respectively (p=0.477). Resolution was observed in 43.8% of children with ceftriaxone-associated gallstone. The rate of resolution with ursodeoxycholic acid (UDCA) was similar to that observed with expectant management. Gallstone resolution was evident in 9 infants (50.0%) and was significantly higher than children over 2 years of age (21 out of 106 children, 19.8%) (p=0.006). The most important factor associated with gallstone resolution was to be an infant (<2 years of age) at the time of diagnosis (OR: 3.1; 95% CI: 1.1-8.8; p=0.034). Conclusion: Ceftriaxone-associated gallstones are most likely to resolve but do not always undergo spontaneous resolution. UDCA treatment seems to be ineffective. Young age is a favorable factor for gallstone resolution. The rate of complications in children with asymptomatic presentation is considerably low. Thus, clinical follow-up rather than surgical intervention is suggested in children with asymptomatic presentation and in infants.

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Section: Discussionmentioning

confidence: 93%

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Gökçe

Yıldırım²,

Erdoğan³

2014

Turk J Gastroenterol

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“…Gallstones are increasingly found in childhood, not only because of the use of ultrasonography in the workup of abdominal pain but also because of the increase of incidence in obesity worldwide and the high frequency of hemolytic anemias in all countries [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…However, the cholecystectomy rate in children without the diagnosis of hemolytic anemia has doubled in United States in recent years [4]. Obesity is a known risk factor for gallbladder disease, and the increase in the incidence of pediatric gallbladder disease parallels the rise in childhood obesity [5].…”

mentioning

confidence: 99%

Management of gallstone disease in children: a new protocol based on the experience of a single center

Tannuri

Leal

Velhote

et al. 2012

Journal of Pediatric Surgery

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“…Recently, however, several studies reported that pediatric cholecystectomy is in an increasing trend. Walker et al [5] [7]. Such an increase in pediatric cholecystectomy may be a result of increases in the average BMI, non-hemolytic cholelithiasis, and biliary dyskinesia [5].…”

Section: Discussionmentioning

confidence: 99%

“…In the past, the comorbidity rate of hemolytic anemia in patients with gallstone disease was reported to be as high as 20% to 25%, but recently it has shown a decreasing trend. In contrast, the prevalence of non-hemolytic gallstone disease has been shown to increase as the prevalence of obesity increases [6,7].…”

Section: Introductionmentioning

confidence: 99%

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

Han

Youn

et al. 2016

J Korean Assoc Pediatr Surg

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Purpose: Number of pediatric cholecystectomy has been recently showing a gradually increasing trend. The purpose of this study was to investigate the clinical features of patients who underwent pediatric cholecystectomy, and the latest trend in cholecystectomy. Methods: In the present study, we conducted a retrospective chart review on 47 patients who had undergone cholecystectomy at a single center. The entire patient population was divided into two groups, according to the time of cholecystectomy (early group, January 1999 to December 2006; late group, January 2007 to August 2014). Results:The comparison between the early and late groups showed that the number of cholecystectomy increased from 13 to 34 cases representing a 2.6-fold increase. The mean patient age also increased from 5.94±4.08 years to 10.51±5.57 years (p=0.01). Meanwhile, laparoscopic surgery also increased from 15.4% to 79.4%, respectively (p＜0.001). However, sex, mean body mass index, comorbidities, indications of cholecystectomy, and previous total parenteral nutrition were not statistically significant. Conclusion:The results of this study showed that pediatric cholecystectomy cases are increasing, particularly in the 10 to 19 years age group and laparoscopic cholecystectomies are also being performed at an increasing rate. When the patients were compared according to the time of cholecystectomy, there were no differences in other risk factors or indications for cholecystectomy.

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Clinical Characteristics and Risk Factors for Symptomatic Pediatric Gallbladder Disease

Abstract: Obesity and Hispanic ethnicity are strongly correlated with symptomatic pediatric gallbladder disease. In comparison with our historical series, hemolytic disease is no longer the predominant risk factor for symptomatic gallstone disease in children.

Cited by 130 publications

References 47 publications

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Management of gallstone disease in children: a new protocol based on the experience of a single center

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

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