Management of cholelithiasis in Italian children: A national multicenter study

Corte, Claudia Della; Falchetti, Diego; Nebbia, Gabriella; Calacoci, M.; Pastore, M.; Francavilla, Ruggiero; Marcellini, Matilde; Vajro, Pietro; Iorio, Raffaele

doi:10.3748/wjg.14.1383

Cited by 51 publications

(52 citation statements)

References 25 publications

(30 reference statements)

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“…The incidence of idiopathic cholelithiasis in other reported series varies from 23 to 52.5%. [56] The trend of the increasing incidence of non-haemolytic cholelithiasis is also reflected in our series, with all of them belonging to the non-haemolytic cholelithiasis category. The mechanism of gallstone formation in these children is probably due to a combination of interacting processes, including, dehydration, transient hepatic dysfunction, dietary, inflammatory, hereditary and endocrine influences, which affect the composition of bile.…”

Section: Discussionsupporting

confidence: 66%

Pediatric cholelithiasis and laparoscopic management: A review of twenty two cases

et al. 2009

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AIM:To evaluate the role of laparoscopic cholecystectomy (LC) in the management of cholelithiasis in children.MATERIALS AND METHODS:A retrospective review of our experience with LC for cholelithiasis at our institution, between April 2006 and March 2009 was done. Data points reviewed included patient demographics, clinical history, haematological investigations, imaging studies, operative techniques, postoperative complications, postoperative recovery and final histopathological diagnosis.RESULTS:During the study period of 36 months, 22 children (10 males and 12 females) with cholelithiasis were treated by LC. The mean age was 9.4 years (range 3 to 18 years). Twenty-one children had symptoms of biliary tract disease and one child was incidentally detected with cholelithiasis during an ultrasonogram of the abdomen for an unrelated cause. Only five (22.7%) children had definitive etiological risk factors for cholelithiasis and the remaining 13(77.3%) cases were idiopathic. Twenty cases had pigmented gallstones and two had cholesterol gallstones. All the 22 patients underwent LC, 21 elective and one emergency LC. The mean operative duration was 74.2 minutes (range 50-180 minutes). Postoperative complications occurred in two (9.1%) patients. The average duration of hospital stay was 4.1 days (range 3-6 days).CONCLUSION:Laparoscopic chloecystectomy is confirmed to be a safe and efficacious treatment for pediatric cholelithiasis. The cause for an increased incidence of pediatric gallstones and their natural history need to be further evaluated.

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Section: Discussionsupporting

confidence: 66%

Pediatric cholelithiasis and laparoscopic management: A review of twenty two cases

et al. 2009

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“…33 Gumiero et al observed in their study that 88 patients had multiple stones and 12 patients had one single gallstone. 24 Dooki and Norouzi reported in their study that 19 (29%) patients had solitary gallstones and in 47 patients (71%) there were multiple gallstones, moreover 3% of the patients had stones simultaneously in the common bile duct (CBD) and 1.5% in cystic duct. 30 Furthermore, 52 patients (65%) had mixed stones.…”

Section: Discussionmentioning

confidence: 96%

“…Familiarity has also been reported in other studies. 8,24 Association of junk food consumption with childhood cholelithiasis could not be established. Obesity in many studies has been documented as major risk factor.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and management of cholelithiasis in children: a hospital based study

2016

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INTRODUCTIONCholelithiasis is quite common in adults (10% to 20%) with worldwide variability. In India, it is 3% to 6%, more frequent in north India than in south India.1 As far as cholelithiasis in children is concerned there is a dramatic change in the overall spectrum of this disease with global increase in the incidence.2 Overall prevalence in Europe is 0.13% to 0.2% in children. In Japan, it is less than 0.13% of children & about 0.3% in India.3,4 Childhood cholelithiasis is evolving with an ever increasing frequency of cholecystectomies in children. 5 Risk factors in childhood cholelithiasis, can be hemolytic causes (20-30%), other known etiology (40-50%) such as total ABSTRACT Background: Earlier cholelithiasis was extremely unusual in childhood. Presently there is sharp increase in detection of cholelithiasis in children, which forms basis to investigate the overall changing pattern of cholelithiasis. This prospective study in referral centre has been under taken to evaluate childhood cholelithiasis and its management. Methods: The present prospective study was conducted in the Postgraduate Department of Surgery, GMC Jammu, Jammu & Kashmir, India over a period of two years. 80 patients in age group of 3-14 years were included in the study group with ultrasound proved cholelithiasis. Data reviewed with respect to patient demographics profile, clinical history including risk factors, imaging studies, operative techniques, postoperative complications, postoperative recovery and primary outcome parameters assessed accordingly. Results: During the study period 80 children (52 males and 28 females) with cholelithiasis were evaluated and treated by laparoscopic cholecystectomy. The mean age was 10.1 years (range 5 to 14 years). 75% patients (n = 60) belonged to rural background and rest to urban set up, 56 patients belonged to hindu religion and rest were muslims. In 47.5% patients no risk factor could be traced. Fifty two children (65%) had mixed gallstones. 78 patients underwent LC, two needed conversion and rest 02 children were subjected to mini cholecystectomy. The mean operative duration was 29.92 minutes (range 15-50 minutes). The average duration of hospital stay was 3.82 days (range 3-8 days). No major intra operative or post-operative complications could be detected except 01 case biliary peritonitis. Conclusions: Cholelithiasis in children was reported about three centuries back, remained relatively uncommon in the past but now it is evolving and ever increasing in frequency. In this part of country in almost 50% of patients risk factors could not be traced, obesity could not be held responsible for cholelithiasis. Male children with low socioeconomic status, rural area and belonging to Hindu religion were more affected by the disease. In view of high incidence of serious complications of gall stones in children and because of longer life expectancy we also recommend that expectant management of gallstones may not be safe and hence laparoscopic cholecystectomy must be done even in asymptomatic cholel...

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“…Erişkin serisinden farklı olarak çocuk hastaların yarısından fazlasında ameliyat önce-si dönemde ursodeoksikolik asit tedavisi başlanmıştı. Çocukluk çağında, asemptomatik veya tesadüfen saptanan safra taşlarına çoğunlukla cerrahi müdahale gerekmez, ancak gerekirse açık cerrahi yerine laparoskopik yaklaşım tercih edilmektedir (10) . Safra kesesi taşları hem erişkinlerde daha sık rastlanmakta hem de kolesistit oluşumu ile semptomatik hâle gelmektedir.…”

Section: Discussionunclassified