Pediatric gallstone disease-Management difficulties in clinical practice

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.