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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Pediatric cholecystectomy for symptomatic gallstones unrelated to hematologic disorder
Sang Gyun Suh1, Yoo-Shin Choi1, Kwi-Won Park1
1Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Insights
Pediatric gallstone disease is rising. Overweight children undergoing cholecystectomy have higher rates of cholesterol stones and complications, requiring careful evaluation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Biliary Tract Disease
Background:
- Gallstone diagnosis is increasing in pediatric populations.
- Symptomatic gallstone disease in children, excluding hemolytic disorders, is the focus.
Purpose of the Study:
- To characterize pediatric patients undergoing cholecystectomy for symptomatic gallstones.
- To identify risk factors and outcomes in this demographic.
Main Methods:
- Retrospective review of pediatric patients (<18 years) who underwent cholecystectomy.
- Study period: May 2005 to December 2015.
- Exclusion of patients with gallstones secondary to hemolytic anemia.
Main Results:
- 19 pediatric patients (9 male, 10 female) underwent cholecystectomy.
- Mean age 14.9 years; 26.37% were overweight with higher rates of cholesterol stones and complicated disease.
- All procedures were laparoscopic with no postoperative complications or mortality.
Conclusions:
- Overweight pediatric patients with gallstones face increased risks of cholesterol stones and complications.
- Increased vigilance for gallstone disease is crucial in pediatric patients presenting with abdominal pain.
- Careful evaluation and management are needed for overweight children with gallstones.
Backgrounds/Aims:
Gallstones are being increasingly diagnosed in pediatric patients. The purpose of this study was to determine characteristics of pediatric patients who underwent cholecystectomy because of symptomatic gallstone disease unrelated to hemolytic disorder.
Methods:
We reviewed cases of pediatric patients (under 18 years old) who underwent cholecystectomy between May 2005 and December 2015.
Results:
A total 20 pediatric patients (under 18 years old) underwent cholecystectomy during the study period. One patient was excluded because cholecystectomy was performed due to gall stones caused by hemolytic anemia. The 19 cases comprised 9 male (47.3%) and 10 female (52.7%) subjects. The mean age was 14.9 years (range, 5-18), and 66.7% of patients were older than 12 years of age. Mean body weight was 65.0 kg (range, 13.9-93.3), and mean body mass index was 21.7 kg/m2 (range, 12.3-35.1), with 26.37% of patients being overweight. All 19 patients underwent laparoscopic cholecystectomy. There were no postoperative complications and no mortality. Comparison between overweight and non-overweight patients indicated that significantly more overweight patients had cholesterol stones (5/5 vs. 7/14, p=0.036) and were classified as complicated disease (3/5 vs. 1/14, p=0.037).
Conclusions:
The more frequent occurrence of complications such as choledocholithiasis or gallstone pancreatitis, in overweight patients indicates the need for more careful evaluation and management in these patients. Pediatricians and surgeons should always consider gallstone disease in pediatric patients despite difficulty in suspecting symptomatic gallstones in cases who present with abdominal pain that is rarely clear-cut.
