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Biliary dyskinesia: the most common indication for cholecystectomy in children
Ravindra K Vegunta1, Mario Raso, Jon Pollock
1University of Illinois College of Medicine at Peoria, USA. vegunta@uic.edu
Insights
Biliary dyskinesia was the most common reason for pediatric cholecystectomy. Surgery offered minimal morbidity and zero mortality, with high rates of symptom resolution and patient satisfaction.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Surgical indications
Background:
- Cholecystectomy in children is increasingly performed.
- Understanding current indications and outcomes is crucial.
Purpose of the Study:
- To examine current indications for pediatric cholecystectomy.
- To evaluate surgical outcomes in children.
Main Methods:
- Retrospective analysis of 107 pediatric cholecystectomies (1998-2003).
- Review of medical and outpatient charts.
- Telephone follow-up for long-term outcomes.
Main Results:
- Biliary dyskinesia (BD) was the most common indication (58%), followed by gallbladder calculus (GC) disease (27%).
- Abdominal pain was the primary symptom; food intolerance was higher in BD.
- Short-term symptom relief was high (85% for BD, 97% for GC); long-term improvement was considerable.
Conclusions:
- BD is the leading indication for pediatric cholecystectomy.
- Surgery has minimal morbidity (1.9% complications) and zero mortality.
- High rates of symptom resolution (95% satisfaction) achieved with outpatient procedures.
Background:
The purpose of this study is to examine the current indications for cholecystectomy in children and to evaluate the results after such surgery.
Methods:
Retrospective analysis of 107 consecutive cholecystectomies performed in children at the Children's Hospital of Illinois between October 1998 and September 2003. Hospital medical charts and outpatient clinic charts were reviewed. Patients' families were contacted by telephone to obtain longer-term follow-up. Results were analyzed with SPSS 12.0 for Windows (SPSS Inc, Chicago, Ill).
Results:
Biliary dyskinesia (BD) was the indication for surgery for 62 (58%) of the 107 children who underwent cholecystectomy during the study period. Gallbladder calculus (GC) disease was the next most common indication with 29 (27%) children. The duration of symptoms was longer for BD. The most common presenting symptom in both groups was abdominal pain. Food intolerance was reported by 45% of patients with BD, significantly higher than patients with GC. Mean length of stay after cholecystectomy was 17 hours and 45 hours for BD and GC, respectively. Short-term follow-up showed relief or improvement of symptoms in 85% of children with BD and in 97% with GC. There were no deaths. Two (1.9%) children of the total of 107 developed complications; both had intra-abdominal abscesses. Most patients had complete or considerable long-term improvement in symptoms.
Conclusions:
Biliary dyskinesia was the most common indication for cholecystectomy in children in our study. More than half of the surgeries were performed on an outpatient basis. Morbidity was minimal and mortality was zero. We had satisfactory short- and long-term symptom resolution with long-term patient satisfaction reaching 95%.
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