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Cholelithiasis management in a third-level pediatric center: case series and literature review

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Abstract

Pediatric cholelithiasis is being increasingly diagnosed owing to the widespread use of ultrasonography, raised pediatric obesity and use of long-time parenteral nutrition. Clinical presentation is variable and complicated onset could lead to severe consequences. The aim of this study is to present a 15-years-experience of a pediatric third-level-center in treating cholelithiasis. A retrospective study collecting children with gallstone operated on between 2006 and 2020 is presented. Demographic data, clinical presentation, sonographic findings, risk factors, surgery, complications, follow-up were evaluated. 199 patients were included. Twenty-nine patients (14.5%) with cholelithiasis had a complicated onset. Patients with cholelithiasis older than 10 years had a higher rate of symptomatic/complicated onset. Hemolytic disease was the most frequent co-morbidity (16.1%). Laparoscopic cholecystectomy was performed in 192 cases (96.5%) with a conversion rate of 1.6%. Nearly 1% showed a major post-operative complication after cholecystectomy. Cholelithiasis in patients older than 10 years can be safely treated with laparoscopic cholecystectomy, especially if one or more co-morbidities are present. Laparoscopic splenectomy can be easily associated in the same procedure depending on medical indication. Definition of pediatric surgical timing guidelines would be of quite interest in the field.

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Funding

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Pediatric Surgery, IRCCS, Istituto Giannina Gaslini, 16147, Genoa, Italy

    M. C. Y. Wong, F. Incerti, S. Avanzini, F. Palo & G. Mattioli

  2. DINOGMI, University of Genoa, Genoa, Italy

    F. Incerti, F. Palo & G. Mattioli

  3. Radiology Department, IRCCS, Istituto Giannina Gaslini, 16147, Genoa, Italy

    F. Sertorio & M. B. Damasio

  4. Pediatric Gastroenterology and Endoscopy Department, IRCCS, Istituto Giannina Gaslini, 16147, Genoa, Italy

    S. Arrigo & P. Gandullia

Authors
  1. M. C. Y. Wong
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  2. F. Incerti
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  3. S. Avanzini
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  4. F. Palo
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  5. F. Sertorio
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  6. M. B. Damasio
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  7. S. Arrigo
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  8. P. Gandullia
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  9. G. Mattioli
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Contributions

MW, FI, FP, FS designed data collection tools, monitored data collection for the whole sample, wrote the statistical analysis plan, cleaned and analyzed the data, and drafted and revised the paper. SA, MBD, SA, PG and GM analyzed the data, drafted and revised the paper.

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Correspondence to M. C. Y. Wong.

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Wong, M.C.Y., Incerti, F., Avanzini, S. et al. Cholelithiasis management in a third-level pediatric center: case series and literature review. Updates Surg 74, 963–968 (2022). https://doi.org/10.1007/s13304-021-01227-9

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  • DOI: https://doi.org/10.1007/s13304-021-01227-9

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