Back to Search Start Over

Pediatric gallstone disease-Management difficulties in clinical practice.

Pediatric gallstone disease-Management difficulties in clinical practice.

Authors :
Losa A
Silva G
Mosca S
Bonet B
Moreira Silva H
Santos Silva E
Source :
Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2024 Jul 08, pp. 502228. Date of Electronic Publication: 2024 Jul 08.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Background: Gallstone disease (GD) is no longer an exclusive condition of adulthood, and its prevalence is increasing in pediatric age. The management and the extent of the etiological investigation of GD in children and adolescents remains controversial. This study aimed to analyze the difficulties in the work-up and management of pediatric GD patients.<br />Methods: A retrospective study performed in a single tertiary center enrolled sixty-five patients with GD followed from January 2014 to June 2021. Patients were categorized conveniently according to their age at diagnosis: Group A (<10years, n=35) and Group B (≥10years, n=30). We analyzed demographic, clinical and laboratory data, ultrasonographic findings at presentation, therapeutics and complications.<br />Results: Symptoms were more frequent in patients >10years old (p=0.001). Cholecystectomy was performed in 31 patients (47.7%). A multivariate regression logistic model identified the age >10years (OR=6.440, p=0.005) and underlying entities (OR=6.823, p=0.017) as independent variables to perform surgery. Spontaneous resolution of GD was more common in children <2years old. A multivariate regression logistic model showed a trend for those >10years old to develop more complications. Two out of 18 patients were diagnosed with ABCB4 gene mutations in heterozygosity.<br />Conclusions: Decision-making on cholecystectomy remains challenging in asymptomatic patients. Identifying predictive factors for the development of complications has proven difficult. However, we found a trend toward the development of complications in individuals older than 10years.<br /> (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)

Details

Language :
English; Spanish; Castilian
ISSN :
0210-5705
Database :
MEDLINE
Journal :
Gastroenterologia y hepatologia
Publication Type :
Academic Journal
Accession number :
38986841
Full Text :
https://doi.org/10.1016/j.gastrohep.2024.502228