Epidemiology, risk factors, management of cholelithiasis in children and review of the literature

Aim of the study: Assessment of risk factors for cholelithiasis in pediatric population. Methods: A retrospective analysis of 143 patients with cholelithiasis treated during the period 2002-2012. Results: There was a significant female predilection for gallstones (73.4%). 70 (48.9%) children showed one or more risk factors for gallstones. 73 (51.1%) patients had no risk factors. Four groups of patients could be distinguished: 106 (74.3%) patients with colicky pain without jaundice, 10 patients with colicky pain with jaundice (7%), 16 (11.2%) children with pancreatitis, 8 (5.5%) with acute cholecystitis, and 3 patients with atypical symptoms (2%). According to therapy, patients could be divided in 3 groups: 130 children treated with laparoscopic cholecystectomy, 4 children treated with laparotomic cholecystectomy and 9 children treated with ursodeoxycholic acid. Conclusions: Laparoscopic cholecystectomy remains the golden standard in treatment for symptomatic cholelithiasis. Complications connected with laparoscopic cholecystectomy were noted in only 2% of patients in our series. Presence of relatives with cholelithiasis, obesity and hemolytic disorders were the predominant risk factors.