Cholecystectomy in Children: Indications and Timing

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Biliary Tract Disease

Background:

• Pediatric cholelithiasis diagnosis is increasing due to better imaging and rising obesity.
• Laparoscopic cholecystectomy is standard, but optimal surgical timing, especially for complicated cases, is debated.

Purpose of the Study:

• To analyze pediatric cholecystectomy patient characteristics.
• To determine the most favorable surgical timing for improved outcomes and reduced complications.

Main Methods:

• Retrospective study of 101 pediatric patients (2015-2024).
• Patients grouped by surgical timing: elective, early (1-4 days), intermediate (5-14 days), delayed (>14 days).
• Analysis of demographic, clinical, laboratory, imaging, operative, and postoperative data.

Main Results:

• Obesity was common and linked to choledocholithiasis and pancreatitis.
• Elective and delayed surgeries had shorter operative times and fewer complications.
• Early surgeries (within 4 days) had longer operative times and more intraoperative difficulties.

Conclusions:

• Elective or delayed cholecystectomy (5-14 day "cool-down") offers best outcomes for complicated pediatric gallstones.
• Conservative management is suitable for asymptomatic cases.
• Standardized surgical timing can decrease complications and healthcare costs.