Clinical characteristics and management evolution of cholelithiasis in a pediatric population: 123 cases experience

Abstract

Introduction: The incidence of cholelithiasis has recently increased in the pediatric population, although it remains a rare disease among children. The purpose of this study is to highlight the management and the appropriate time to perform surgery. Materials and Methods: We performed a retrospective study over 10 years (2010-2010) and we found 123 patients who presented with biliary lithiasis and who underwent surgery in our department. We divided the study population into two groups depending on the time of admission and we found that in the 2010-2015 period we had a number of 33 patients, while in the last 5 years we admitted 90 patients with this diagnosis. Patients with other conditions such as bile duct atresia, choledochal cyst, hepatoblastoma that required a cholecystectomy were excluded from our study. Results: After analyzing the two groups we concluded that the number of surgical procedures increased from 33 to 90, which represents a 2.6 times increase. There was no significant difference between the two groups regarding the average age on admission (12.6 +/- 3.37 in the first group vs. 13.91 +/-3.34 in the second group). Surgical management of lithiasis cholecystitis registered an important difference in the two groups. In the first group, 9 patients (27.3%) underwent classic cholecystectomy while 24 (72.7%) – patients benefited from the laparoscopic approach, while in the second group just one patient underwent open surgery with 89 (98.9%) patients undergoing laparoscopic surgery. The percentage of patients who benefited from surgery in the same hospitalization remained high in both groups studied with a statistically significant p-value (p = 0.0417). Conclusion: The number of cases with cholecystitis and lithiasis is increasing in the pediatric population. Surgical management for these patients has become similar to that of adult patients, with minimally invasive surgery becoming the gold standard approach.