Gallbladder disease, primary cholelithiasis, or gallbladder hydrops: review of 32 children

Abstract

Gallbladder disease is generally considered uncommon in childhood, but in recent years the frequency seems to be increasing. Therefore, a review was made of children appearing with gallbladder disease during the past 10 years at the Department of Pediatric Surgery, St. Göran's Hospital, Stockholm. There were 32 patients, 15 boys and 17 girls. Two-thirds of the cases were diagnosed in 1988 or later. One-half were younger than 8 years; 7 were 2 years old or younger. Hemolytic disease was found in 2/32 patients. One patient had received total parenteral nutrition, but only for a period of 10 days. In 6/32 children the symptoms were interpreted to be caused by gallbladder dysfunction, either as intermittent hydrops or a defect of emptying after a fatty meal. One of these 6 also had a stone. Surgery was performed in 22 children: cholecystectomy in 15 and cholecystotomy with stone extraction in 7. Analysis of 14 stones showed that pigmentary stones were most common. We conclude that gallbladder disease in children seems to be increasing. The preoperative examination should include both ultrasound and cholecystography. We also find that stone extraction is an adequate procedure if there is good gallbladder function and no sign of cholecystitis.