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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,532
Minerva Pediatrica 2014 August;66(4):267-73
Management of pediatric cholelitiasis: our experience
Cofini M. 1, Favoriti P. 2, Pietrantoni S. 3, Quadrozzi F. 3 ✉
1 Clinica Pediatrica, Università di Perugia, Perugia, Italia;
2 Unità Operativa Complessa di Chirurgia Generale, Policlinico Ospedale di Avezzano, L’Aquila, Italia;
3 Scuola di Specializzazione in Chirurgia Generale, Università di L’Aquila, L’Aquila, Italia
AIM: The aim of this retrospective study was to report our experience about characteristics of clinical presentation, etiologies, diagnosis and medical or surgical treatment of pediatric cholelitiasis.
METHODS: Twenty-four children, ranging from 7 to 17 years of age (14 females and 10 males), with diagnosis of cholelitiasis were studied from 2008 through 2011. Exclusion criteria included: active infection, cholangitis, severe anemia or thrombocytopenia in cases with hemolytic diseases. Diagnosis was performed with abdominal ultrasonography-scanner (US). Furthermore, complete peripheral blood examination was performed to all patients. Follow-up was conducted by clinical and US and/or CT supports between 6 and 24 months.
RESULTS: Laparoscopic cholecystectomy was performed in 16 patients, conservative management in 10. No cases of majority morbility or death rate were found. RMN-colangiography was conducted in 2 cases with cholestasis elevated index: no stone were found in common bile duct. During follow-up evaluation, 2 patients began sympotimatic and were undergone to cholecystectomy. “Wait and see” management was performed in all asymptomatic cases. In only 2 cases ursodeoxycholic acid (UDCA) was administrated.
CONCLUSION: Laparoscopic cholecystectomy is a “gold standard” also for a treatment of cholelitiasis in childhood; it is an efficacy and safe treatment also for pediatric gallstones. Medical therapy with UDCA lead not to dissolution of gallstones but it had a positive effect on the symptoms.