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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Gallstone disease in children.

Ujjal Poddar1

  • 1Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, Uttar Pradesh, India. ujjalpoddar@hotmail.com

Indian Pediatrics
|December 15, 2010
PubMed
Summary
This summary is machine-generated.

Gallstones in children are increasingly diagnosed, with varied causes like hemolytic disorders and TPN. Observation is recommended for infants, while prophylactic cholecystectomy is advised for hemolytic conditions.

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Area of Science:

  • Pediatric Gastroenterology
  • Hepatobiliary Diseases
  • Pediatric Surgery

Background:

  • Cholelithiasis (gallstones) and choledocholithiasis (bile duct stones) are increasingly diagnosed in children, largely due to widespread ultrasonography use.
  • Limited epidemiological data exists for pediatric gallstones in India, with no consensus on management among specialists.
  • This review aims to raise awareness regarding the diagnosis and management of gallstones in pediatric populations.

Purpose of the Study:

  • To review the current understanding of pediatric cholelithiasis epidemiology and management.
  • To increase awareness among healthcare professionals regarding gallstone management in children.
  • To provide insights into the various etiologies and clinical presentations of gallstones in pediatric patients.

Main Methods:

  • An extensive electronic literature search was conducted using PubMed.
  • Reviewed original articles, clinical trials, case series, and review articles related to gallstones in children.
  • Synthesized findings to provide a comprehensive overview of the topic.

Main Results:

  • Etiologies of cholelithiasis include hemolytic conditions (20-30%), other known factors like total parenteral nutrition (TPN) and ileal disease (40-50%), and idiopathic causes (30-40%).
  • Spontaneous resolution of gallstones is common in infants, warranting observation even for bile duct stones.
  • Children present with typical biliary symptoms (50%), nonspecific symptoms (25%), are asymptomatic (20%), or have complications (5-10%).

Conclusions:

  • Cholecystectomy (gallbladder removal) is beneficial for children with typical biliary symptoms but not recommended for those with nonspecific symptoms.
  • Prophylactic cholecystectomy is advised for children with hemolytic disorders.
  • A period of observation is recommended for infants with gallstones, including those with bile duct stones, due to frequent spontaneous resolution.