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Pediatric gallstone disease-Management difficulties in clinical practice

Ana Losa1, Gisela Silva2, Sara Mosca1

  • 1Department of Pediatrics, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal.

Gastroenterologia Y Hepatologia
|July 10, 2024
PubMed

Insights

Pediatric gallstone disease (GD) management is challenging. Older children (>10 years) and those with underlying conditions are more likely to need surgery, while younger children (<2 years) may see spontaneous resolution.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Surgical Management

Background:

  • Gallstone disease (GD) is increasingly diagnosed in children and adolescents.
  • Management and etiological investigation of pediatric GD are controversial.
  • This study addresses challenges in the diagnosis and management of pediatric GD.

Purpose of the Study:

  • To analyze the difficulties in the work-up and management of pediatric gallstone disease patients.
  • To identify factors influencing surgical decisions and complications in pediatric GD.
  • To investigate the clinical presentation and outcomes of pediatric gallstone disease.

Main Methods:

  • Retrospective study of 65 pediatric patients with GD (January 2014 - June 2021).
  • Patients divided into two age groups: <10 years (Group A) and ≥10 years (Group B).
  • Analysis of demographic, clinical, laboratory, ultrasonographic data, treatments, and complications.

Main Results:

  • Symptoms were more frequent in patients aged ≥10 years (p=0.001).
  • Cholecystectomy was performed in 47.7% of patients; age >10 years and underlying conditions predicted surgery.
  • Spontaneous resolution occurred more in children <2 years; a trend for more complications was observed in those >10 years.

Conclusions:

  • Challenging decision-making for cholecystectomy in asymptomatic pediatric patients.
  • Predictive factors for complications in pediatric GD remain difficult to identify.
  • A trend suggests increased complications in pediatric GD patients over 10 years old.
Abstract

Keywords:
CholecystectomyCholelithiasisColecistectomíaColelitiasisCálculos biliaresGallstonesPediatricsPediatría

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