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Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease

Seema Mehta1, Monica E Lopez, Bruno P Chumpitazi

  • 1Department of Pediatrics, Baylor College of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, Texas Children’s Hospital, Houston, Texas, USA. seemam@bcm.edu

Pediatrics
|December 14, 2011
PubMed

Insights

Pediatric gallbladder disease is increasingly linked to obesity and Hispanic ethnicity. Compared to historical data, these factors are now more significant than hemolytic disease in children requiring cholecystectomy.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Public Health

Background:

  • Pediatric gallbladder disease and cholecystectomies were previously studied at our center from 1980 to 1996.
  • Current trends in pediatric gallbladder disease require updated clinical characteristics and risk factor analysis.

Purpose of the Study:

  • To determine current clinical characteristics of symptomatic pediatric gallbladder disease.
  • To identify risk factors for pediatric cholecystectomies.
  • To compare current findings with historical data from 1980-1996.

Main Methods:

  • Retrospective, cross-sectional study.
  • Inclusion criteria: Children aged 0-18 years who underwent cholecystectomy between January 2005 and October 2008.
  • Data analysis included patient demographics, indications for surgery, and body mass index (BMI) percentiles.

Main Results:

  • 404 patients were evaluated; 73% were girls, 39% Hispanic, and 35% white. Mean age was 13.10 years.
  • Primary surgical indications included symptomatic cholelithiasis (53%), obstructive disease (28%), and biliary dyskinesia (16%).
  • Obesity was prevalent (median BMI percentile 89%), with 39% classified as obese. Hispanic ethnicity and older age were independent risk factors for nonhemolytic gallstone disease. Compared to historical data, patients were more likely to be Hispanic and severely obese.

Conclusions:

  • Obesity and Hispanic ethnicity are strongly associated with symptomatic pediatric gallbladder disease.
  • Hemolytic disease is no longer the primary risk factor for symptomatic gallstone disease in children.
  • These findings highlight a shift in risk factors for pediatric gallbladder disease, emphasizing the impact of obesity and ethnicity.
Abstract

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