Paediatric gallstones and laparoscopic cholecystectomy

D. G. Samuel, N. N. Naguib, A. Y. Izzidien

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DOI: 10.4236/health.2010.21011                

Abstract

Introduction: Gall stones disease is a rare oc-currence in paediatric patients and the diagno-sis is often overlooked. Patients often present with non-specific symptoms of abdominal pain and the classic features of gallstones are some-times absent [1]. The aim of our study is to in-crease the awareness of cholecystitis and acute pancreatitis being a possible occurrence in the paediatric age group and should therefore be in the differential diagnosis of acute abdominal pain in children. We undertook a retrospective analy- sis of all the paediatric patients recorded as hav- ing had a laparoscopic Cholecystectomy per-formed at Prince Charles Hospital. 8 paediatric patients underwent Laparoscopic cholecysteco- my between 2000 and 2008 consisting of 5 fe-male patients and 3 male patients. The average age of the cohort was 14.1 years [12-16]. Pre- morbid obesity was a feature in 4 patients and all patients reported high fat diet. Abdominal Ul- trasound used to assess all 8 patients who pre- sented with acute abdomen showed gallstones to be present in all. 7 patients underwent an ele- ctive procedure 3-6 months after the initial di-agnosis was made and 1 patient had laparosco- pic Cholecystectomy within 72 hours of initial presentation. 1 patient was found to have an in- herited haematological disorder and 2 of the pa- tients were sisters with a family history of gall- stone disease. 2 patients presented with acute pancreatitis. Gallstone related cholecystitis is a rare occurrence amongst paediatric patients and is often overlooked as a differential diagnosis. We report 8 patients over an 8 year period. Con- clusion: It is important that clinicians include cholecystitis and biliary colic in the differential diagnosis of patients presenting with acute ab-domen in childhood not explained by other di-agnoses. Laparoscopic Cholecystectomy is the treatment of choice and has minimal complica-tions.

Keywords

Gallstones; Cholecystitis; Paediatrics; Laparoscopic Cholecystecomy

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Sutton, R. and Cheslyn-curtis, S. (2001) Acute gallstone pancreatitis in childhood. Ann R Coll Surg Engl, 83, 406- 408.
[2]	Bruck, S.W., Sigmund, H.E., Rocchi, C. and Kim, P.C.W. The management of nonpigmented gallstones in children. Journ Paediatr Surg, 35, 729-732.
[3]	Davenport, M. (2003) Laparoscopic surgery in children review. Ann R Coll Surg Engl, 85, 324-330.
[4]	Haddock, G., Coupar, G., Youngson, G.G., MacKinlay, G.A. and Raine, P.A. (1994) Acute pancreatitis in children: A 15-year review. J Paediatr Surg, 29, 719-22
[5]	Lerner, A., Branski, D. and Lebenthal, E. (1996) Pancre-atic diseases in children. Paediatr Clin North Am, 43, 125- 56.
[6]	De Caluwe, D., Akl, U. and Corbally, M. Cholecystectomy verus cholecystolithotomy for cholelithiasis in childhood: Long-term outcome. Journ Paedr Surg., 36(10), 1518- 1521.
[7]	St Peter, S.D., Keckler, S.J., Nair, A., Andrews, W.S., Sharp, R.J. et al. (2008) Laparascopic cholecystectomy in the paediatric population. J Laparoendosc Adv Tech A., 18(1), 127-30.
[8]	Weizman, Z. and Durie, P.R. (1988) Acute pancreatitis in childhood. J Paediatr, 113, 24-9
[9]	Lowe, M.E. and Greer, J.B. (2008) Pancreatitis in chil-dren and adolescents. Curr Gastroenterol Rep., 10(2), 128-35.