Related Experiment Video
Updated: May 27, 2025
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
PEDIATRIC CHOLELITHIASIS AND FACTORS ASSOCIATED WITH CHOLECYSTECTOMY
Karyne Sumico de Lima Uyeno Jordão1, Matheus Guedes da Silva1, Gabriel Hessel1
1Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brasil.
Insights
Pediatric cholelithiasis (gallstones) often presents with abdominal pain. While cholecystectomy is common, expectant management is a viable option for select pediatric patients with gallstones, showing no complications.
Area of Science:
- Pediatric Gastroenterology
- Hepatobiliary Surgery
- Medical Diagnostics
Background:
- Cholelithiasis (gallstones) involves hardened deposits in the gallbladder, causing symptoms like abdominal pain, jaundice, and nausea.
- Potential complications include cholecystitis and choledocholithiasis.
- Limited literature and undefined protocols exist for pediatric cholelithiasis.
Purpose of the Study:
- To evaluate clinical and laboratory characteristics of pediatric cholelithiasis.
- To assess outcomes in pediatric patients with gallstones.
- To identify factors associated with cholecystectomy in children.
Main Methods:
- Retrospective case series of pediatric patients diagnosed with cholelithiasis via ultrasound (2007-2021).
- Assessment of clinical profiles, comorbidities, and patient evolution.
- Categorization into groups: no cholecystectomy (NC) and cholecystectomy (C).
Main Results:
- Thirty-five pediatric patients included; 60% had comorbidities.
- Abdominal pain was the predominant symptom, significantly higher in the cholecystectomy group (P=0.04).
- Expectant management (Group NC) was chosen by 12 patients; 21 underwent cholecystectomy (Group C).
Conclusions:
- Abdominal pain is a key symptom in pediatric cholelithiasis cases requiring intervention.
- Comorbidities and lab abnormalities were not significant predictors for cholecystectomy.
- Expectant management is a viable option for select pediatric gallstone cases, avoiding complications.
Background:
Cholelithiasis, characterized by hardened deposits in the gallbladder, presents symptoms such as abdominal pain, jaundice, nausea, and potential complications like cholecystitis and choledocholithiasis. Despite increasing diagnoses, literature on pediatric cholelithiasis is limited, with undefined protocols.
Objective:
This study aims to evaluate the clinical, laboratory characteristics, and outcomes of pediatric cholelithiasis cases, identifying factors associated with cholecystectomy.
Methods:
A retrospective case series study was conducted on patients treated at a tertiary service, diagnosed with cholelithiasis via ultrasound from 2007 to 2021. Clinical profiles, comorbidities, examinations, procedures, and patient evolution were assessed. Patients were categorized into two groups: Group NC (no cholecystectomy) and Group C (cholecystectomy).
Results:
Thirty-five patients were included, with 51% females and 60% having comorbidities with abdominal pain was the predominant symptom. Thirty-three patients were managed outpatient while two patients continued follow-up at another facility. Twelve opted for expectant management (Group NC), while 21 underwent cholecystectomy (Group C). Elective laparoscopic cholecystectomy was performed in Group C, with a median age of 11 years and 3 months. Group C showed a higher frequency of abdominal pain compared to Group NC, and this difference was significant (P=0.04). No differences were observed in gender, comorbidities, jaundice, fever, laboratory findings, symptom duration, follow-up time, or age at diagnosis. The median follow-up duration in Group NC was 1 year and 7 months.
Conclusion:
Abdominal pain was the predominant symptom in patients undergoing cholecystectomy, while comorbidities and laboratory abnormalities showed no significant associations. Although surgical intervention is typically recommended, expectant management proved viable in select cases without ensuing complications during the evaluation period.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...