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Gallbladder disease in childhood.

H Takiff, E W Fonkalsrud

    American Journal of Diseases of Children (1960)
    |June 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    Gallbladder surgery in children is safe and effective. Calculous cholecystitis causes in children include total parenteral nutrition, while other risk factors for gallbladder disease in pediatric patients are female sex, obesity, and family history.

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    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Biliary System Diseases

    Background:

    • Cholecystectomy is a common surgical procedure for gallbladder disease.
    • Gallbladder disease in children is less common than in adults but requires specific consideration.
    • Understanding the etiologies and outcomes of pediatric cholecystectomy is crucial for clinical practice.

    Purpose of the Study:

    • To analyze the indications, etiologies, and outcomes of cholecystectomy in children.
    • To identify risk factors and diagnostic methods for pediatric cholelithiasis.
    • To evaluate the safety and efficacy of cholecystectomy in pediatric patients with various biliary conditions.

    Main Methods:

    • Retrospective review of 77 pediatric patients (<19 years) who underwent cholecystectomy over a 12-year period.

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  • Categorization of patients into calculous cholecystitis, acalculous cholecystitis, and those undergoing cholecystectomy with other biliary surgery.
  • Analysis of identified etiologies for cholelithiasis, patient demographics, and diagnostic imaging (ultrasound, oral cholecystogram).

    • Main Results:

    • 44 patients had calculous cholecystitis, 5 had acalculous cholecystitis, and 28 had other major biliary surgery.
    • Identifiable causes for cholelithiasis were found in over half of calculous cases, most commonly total parenteral nutrition.
    • Children without identifiable etiology for cholelithiasis were predominantly female, older, obese, with a family history, and adult-like symptoms.
    • Ultrasound and oral cholecystogram were the most effective imaging modalities for diagnosing cholelithiasis.
    • Cholecystectomy combined with reconstruction benefited children with biliary atresia, choledochal cysts, and other extrahepatic biliary anomalies.
    • Mortality and morbidity rates were low and not associated with the cholecystectomy procedure itself.

    Conclusions:

    • Cholecystectomy is a safe and effective procedure for pediatric patients with various gallbladder and biliary conditions.
    • Total parenteral nutrition is a significant risk factor for cholelithiasis in children, while female sex, obesity, and family history are associated with idiopathic cases.
    • Surgical intervention, including reconstruction when necessary, leads to favorable outcomes in complex pediatric biliary diseases.