Pediatric Surgery International

, Volume 34, Issue 8, pp 845–849 | Cite as

Is 14 the new 40: trends in gallstone disease and cholecystectomy in Australian children

  • Douglas GreerEmail author
  • Sean Heywood
  • David Croaker
  • Siva Gananadha
Original Article



Gallstone disease and cholecystectomy have been uncommon in paediatric patients and associated with haemolytic disease and prematurity. Many countries have observed an increase in the prevalence of paediatric gallstones and cholecystectomy with increasing childhood obesity. The purpose of this study was to determine any trend in prevalence in Australian children and the role of obesity.


Chart review was conducted for patients undergoing cholecystectomy under 18 in 25 years between 1992 and 2016. Patients were grouped based on year of operation into five groups of 5 years each. Patient demographics including age and gender were noted, as were weight, height, and percentiles. Also noted were comorbidities, indication for surgery, whether elective or emergent, and procedure performed. Statistical analysis was performed using logistic regression on R-Studio®.


Seventy-nine patients were included, 9, 15, 18, 18, and 19 in Groups 1–5, respectively. A trend was noted of increasing frequency which did not reach statistical significance. Nineteen patients had alternative explanations for gallstone disease, decreasing over time, coefficient − 10.5. A trend was also noted of increasing proportion of patients in higher percentiles for weight, which was statistically significant for those above the 98th percentile.


The changing profile of paediatric cholecystectomy is a little recognised aspect of the ‘obesity epidemic’. This has implications when considering the impact of childhood overweight and obesity, and for clinicians involved in the diagnosis and management of these children.


Cholecystectomy Childhood obesity Gallstones 




Compliance with ethical standards

Conflict of interest

The authors have nothing to disclose.

Ethical approval

Approval was obtained from the Canberra Hospital Low Risk Ethics Committee.

Informed consent



  1. 1.
    Kang J-Y, Ellis C, Majeed A et al (2003) Gallstones—an increasing problem: a study of hospital admissions in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther 17:561–569CrossRefPubMedGoogle Scholar
  2. 2.
    Plant JC, Percy I, Bates T, Gastard J, De Nercy YH (1973) Incidence of gallbladder disease in Canada, England, and France. Lancet 2:249–251CrossRefPubMedGoogle Scholar
  3. 3.
    Holland C, Heaton KW (1972) Increasing frequency of gall bladder operations in the Bristol clinical area. Br Med J 3:672–675CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Beckingham IJ (2001) Gallstone disease. Br Med J 322:91–94CrossRefGoogle Scholar
  5. 5.
    Balaguer EJ, Price MR, Burd RS (2006) National trends in the utilization of cholecystectomy in children. J Surg Res 134:68–73CrossRefPubMedGoogle Scholar
  6. 6.
    Mehta S, Lopez ME, Chumpitazi BP, Mazziotti MV, Brandt ML, Fishman DS (2012) Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease. Pediatrics 129:82–88CrossRefGoogle Scholar
  7. 7.
    Suh SG, Choi Y-S, Park K-W, Lee SE (2016) Pediatric cholecystectomy for symptomatic gallstones unrelated to hematologic disorder. Ann Hepatobiliary Pancreat Surg 20:187–190CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Kaechele V, Wabitsch M, Thiere D et al (2006) Prevalence of gallbladder stone disease in obese children and adolescents: Influence of the degree of obesity, sex, and pubertal development. J Pediatr Gastroenterol Nutr 42:66–70CrossRefPubMedGoogle Scholar
  9. 9.
    Matta SR, Kovacic K, Yan K, Simpson P, Sood MR (2017) Trends of cholecystectomies for presumed biliary dyskinesia in children in the United States. J Pediatr Gastroenterol Nutr. (Epub ahead of print) (journal on the internet) PubMedCrossRefGoogle Scholar
  10. 10.
    Al-Homaidhi HS, Sukerek H, Klein M, Tolia V (2002) Biliary dyskinesia in children. Pediatr Surg Int 18:357–360CrossRefPubMedGoogle Scholar
  11. 11.
    Beck PL, Shaffer EA, Gall DG, Sherman PM (2007) The natural history and significance of ultrasound defined polypoid lesions of the gallbladder in children. J Pediatr Surg 42:1907–1912CrossRefPubMedGoogle Scholar
  12. 12.
    Olds TS, Tomkinson GR, Ferrar KE, Maher CA (2010) Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. Int J Obesity 34:57–66CrossRefGoogle Scholar
  13. 13.
    Hardy LL, Mihrshahi S, Gale J, Drayton BA, Bauman A, Mitchell J (2017) 30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015. Int J Obesity 41:76–82CrossRefGoogle Scholar
  14. 14.
    Mihrshahi S, Drayton BA, Bauman AE, Hardy LL (2017) Associations between childhood overweight, obesity, abdominal obesity and obesogenic behaviors and practices in Australian homes. BMC Public Health 18:44CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Langballe KO, Bardram L (2014) Cholecystectomy in Danish children—a nationwide study. J Pediatr Surg 49:626–630CrossRefPubMedGoogle Scholar
  16. 16.
    Waldhausen J, Benjamin D (1999) Cholecystectomy is becoming an increasingly common operation in children. Am J Surg 177:364–367CrossRefPubMedGoogle Scholar
  17. 17.
    Bailey PV, Connors RH, Tracy TJ Jr et al (1989) Changing spectrum of cholelithiasis and cholecystitis in infants and children. Am J Surg 158:585–588CrossRefPubMedGoogle Scholar
  18. 18.
    Khoo AK, Cartwright R, Berry S et al (2014) Cholecystectomy in English children: evidence of an epidemic (1997–2012). J Pediatr Surg 49:284–288CrossRefPubMedGoogle Scholar
  19. 19.
    Kumar R, Nguyen K, Shun A (2000) Gallstones and common bile duct calculi in infancy and childhood. Aust NZ J Surg 70:188–191CrossRefGoogle Scholar
  20. 20.
    De Bari O, Wang T, Liu M, Paik CN, Portincasa P, Wang D (2014) Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment. Ann Hepatol 13:728–745PubMedGoogle Scholar
  21. 21.
    Angelin B, Olivecrona H, Reihner E et al (1992) Hepatic cholesterol metabolism in estrogen-treated men. Gastroenterology 103:1657–1663CrossRefPubMedGoogle Scholar
  22. 22.
    Rosenfield R, Lipton R, Drum M (2009) Thelarche, pubarche and menarche attainment in children with normal and elevated body mass index. Pediatrics 123:84–144CrossRefPubMedGoogle Scholar
  23. 23.
    Davison K, Susman E, Birch L (2003) Percentage body fat at age 5 predicts earlier pubertal development among girls at age 9. Pediatr 111:815–821CrossRefGoogle Scholar
  24. 24.
    Miltenburg D, Schaffer R, Breslin T et al (2000) Changing indications for paediatric cholecystectomy. Pediatrics 105:1250–1253CrossRefPubMedGoogle Scholar
  25. 25.
    Campbell S, Richardon B, Mishra P et al (2016) Childhood cholecystectomy in New Zealand: a multicenter national 10 year perspective. J Pediatr Surg 51:264–267CrossRefPubMedGoogle Scholar
  26. 26.
    Australian Bureau of Statistics (1996) Census of population and housing [PDF on internet]. Canberra, Australia (updated 3 July 2008). Accessed 10 Feb 2018
  27. 27.
    Australian Bureau of Statistics (2016) Census QuickStats: Canberra-Queanbeyan (Canberra part). [webpage] Canberra, Australia (updated 12 Jan 2017). Accessed 10 Feb 2018
  28. 28.
    Greenberg M, Kangarloo H, Cochran ST, Sample WF (1980) The ultrasonographic diagnosis of cholecystitis and cholelithiasis in children. Radiology 137:745–749CrossRefPubMedGoogle Scholar
  29. 29.
    Robertson J, Carachi R, Sweet E, Raine P (1988) Cholelithiasis in childhood: a follow-up study. J Pediatr Surg 23:246–249CrossRefPubMedGoogle Scholar
  30. 30.
    Bogue C, Murphy A, Gerstle J, Moineddin R, Daneman A (2010) Risk factors, complications, and outcomes of gallstones in children: a single-centre review. J Pediatr Gastroenterol Nutr 50:303–308CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Douglas Greer
    • 1
    • 3
    Email author
  • Sean Heywood
    • 1
  • David Croaker
    • 1
    • 2
  • Siva Gananadha
    • 1
    • 2
  1. 1.The Canberra HospitalCanberraAustralia
  2. 2.Australian National UniversityCanberraAustralia
  3. 3.AlexandriaAustralia

Personalised recommendations