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PEDIATRIC CHOLELITHIASIS AND FACTORS ASSOCIATED WITH CHOLECYSTECTOMY.

Karyne Sumico de Lima Uyeno Jordão1, Matheus Guedes da Silva1, Gabriel Hessel1

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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.

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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.