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Follow-up study of gallbladder stones in 44 children
Jian-Xiong Yu1, Zhi-Zhong Jiang1, Yuan-Hao Cai1
1Department of Pediatric, The Firs Affiliated Hospital of Naval Medical University, Shanghai 20000, China.
Insights
Gallstones in children are common in adolescents, often linked to metabolic issues. Gallbladder surgery, including laparoscopic cholecystectomy, is effective and does not impact growth.
Area of Science:
- Pediatric Gastroenterology
- Surgical Outcomes
- Pediatric Endocrinology
Background:
- Gallstones affect a subset of children, raising concerns about surgical impacts on growth.
- Understanding pediatric gallstone characteristics is crucial for effective management.
Purpose of the Study:
- To investigate the population demographics, clinical presentations, treatment strategies, and long-term outcomes of gallstones in pediatric patients.
- To evaluate the effect of gallbladder surgery on the growth and development of children and adolescents.
Main Methods:
- Retrospective analysis of clinical data from 44 children with gallstones (2009-2021).
- Follow-up via telephone for prognoses (minimum 2 years, 6 months).
- Comparison of outcomes between surgical (n=28) and non-surgical (n=16) groups, focusing on growth parameters.
Main Results:
- Gallstones predominantly affect adolescents (84.09%), with no distinct sex predilection.
- Overweight/obesity (29.55%) and underlying conditions like metabolic abnormalities (26 cases) and hemolytic anemia (9 cases) are common.
- Recurrent symptomatic gallstones occurred in 68.18%; laparoscopic cholecystectomy was the primary surgical approach (71.43% of surgeries).
- No significant differences in symptoms, complications, or growth (height attainment, curve shift) were observed between surgical and non-surgical groups.
Conclusions:
- Pediatric gallstones are most prevalent in adolescents, often associated with congenital factors, metabolic disorders, and hemolytic anemia.
- Recurrent symptomatic gallstones are frequent in this population.
- Surgical intervention, particularly laparoscopic cholecystectomy, is the main treatment and does not adversely affect children's growth and development.
Background:
Cholesterol stones affect a certain subpopulation of children. Concerns have been raised on the impact of gallbladder surgery on the growth of children and adolescents.
Aim:
To study the population characteristics, clinical features, treatment, and prognosis of gallstones in children.
Methods:
The clinical data of 44 children with gallstones admitted to The First Affiliated Hospital of Naval Medical University from August 2009 to August 2021 were collected, the children were followed up by telephone to monitor their prognoses. The follow-up ended in August 2023. The shortest follow-up time was 2 years and 6 months, whereas the longest was 13 years and 11 months. The population characteristics, general clinical characteristics, and treatments were retrospectively analyzed. The children were divided according to whether they underwent surgical gallbladder removal into an operation group (n = 28) and a non-operation group (n = 16), The effects of surgical gallbladder resection on the growth and development of children were analyzed.
Results:
The male-female ratio in the population was 6:5 and 84.09% of the children had onset in adolescence. Furthermore, 29.55% of the children were overweight or obese. The study identified 26 cases with metabolic abnormalities, 9 with hemolytic anemia, and 4 with choledochal cyst. Of the population, 68.18% had recurrent symptomatic cholecystolithiasis. Surgical treatment accounted for 63.64%, with laparoscopic cholecystectomy accounting for 71.43% of surgical treatment. No significant differences were observed in symptoms and complications between the surgery and non-surgery groups. Furthermore, no significant differences were found between the two groups in the attainment of genetic height target and the rightward shift of height curve during follow-up.
Conclusion:
The sex characteristics of gallstones in children were not observed. Most gallstones occurred in adolescents and rarely in young children. A considerable proportion of children have inborn causes, which are often concurrent with metabolic abnormalities and hemolytic anemia. Most children had recurrent symptomatic gallstones. Surgical treatment, especially laparoscopic cholecystectomy, is still the main treatment for gallstones in children. Surgical treatment did not affect the growth and development of children who underwent gallstone removal.
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