[Predisposing factors and results of pharmalogical treatment using ursodeoxycholic acid of gallbladder stones in children].
Gallbladder stones (GBS) in adults is one of the most often disease of the gastrointestinal tract, it occurs in about 0.2% of children. Risk factors of the GBS in children are different that those in adults. Therapeutical standards in GBS depend on the age, clinical symptoms, complications and coexistent diseases.


OBJECTIVE
The estimation and comparison of risk factors of GBS in children in two periods (1989-1996 and 1997-2004), and the estimation of the results of the pharmacological treatment with UDCA.


METHODS
In 112 children aged from 3 months to 18 yrs. with GBS recognized in the period of 1989-2004 the estimation and comparison of the frequency of risk factors in two periods: 1989-1996 (39 children aged from 4 months to 17 yrs.) and in years 1997-2004 (73 children aged from 3 months to 18 yrs.) was done. In the second step we analyzed results of pharmacological treatment with UDCA in 41 children after completion of the therapy. Only children with noncalcifying stones smaller than <15 mm in diameter were qualified to the treatment. Statistical analysis (chi2-test) was used to estimate results of the analysis.


RESULTS
Gallbladder stones was recognized more often in girls (65%), obesity was present in 42% of children, family history of the GBS was positive in 28.6%, prior severe disease (e.g. sepsis) in 15.9%. In 16% of children GBS was idiopathic. In the period of 1997-2004 significantly more often than in the period of 1989-1996 in children with GBS were observed: serum lipid abnormalities (28.4 vs. 10.3%; p < 0.03), prior severe diseases requiring intensive care (21.6 vs. 5.1%; p = 0.02) and intensive reducing of the body weight (9.5 vs. 0%; p < 0.05). Any of the risk factors had influence on the positive result of pharmacological treatment. Dissolution of the small stones (<5 mm) in comparison with stones bigger than 10 mm (p < 0.05) was observed significantly more often.


CONCLUSIONS
(1) Gallbladder stones in children was observed more often in girls, children with prior severe disease, and in obese children with the positive family history of GBS. (2) Good results of pharmacological treatment of GBS in children depends on the size of the stones. (3) Risk factors of the GBS have no significant influence to the positive result of the pharmacological treatment using UDCA in children.
Stawarski
Andrzej
A
Akademia Medyczna we Wroclawiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia. as.stawarski@poczta.onet.pl
Iwańczak
Barbara
B
Iwańczak
Franciszek
F
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002756:Cholagogues and Choleretics / Q000494:pharmacology* / Q000627:therapeutic use*; D041761:Cholecystolithiasis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000453:epidemiology; D014580:Ursodeoxycholic Acid / Q000494:pharmacology* / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid