title: Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease.
abstract: OBJECTIVE
  Our center previously reported its experience with pediatric gallbladder disease and cholecystectomies from 1980 to 1996. We aimed to determine the current clinical characteristics and risk factors for symptomatic pediatric gallbladder disease and cholecystectomies and compare these findings with our historical series.
  
  
  METHODS
  Retrospective, cross-sectional study of children, 0 to 18 years of age, who underwent a cholecystectomy from January 2005 to October 2008.
  
  
  RESULTS
  We evaluated 404 patients: 73% girls; 39% Hispanic and 35% white. The mean age was 13.10 ± 0.91 years. The primary indications for surgery in patients 3 years or older were symptomatic cholelithiasis (53%), obstructive disease (28%), and biliary dyskinesia (16%). The median BMI percentile was 89%; 39% were classified as obese. Of the patients with nonhemolytic gallstone disease, 35% were obese and 18% were severely obese; BMI percentile was 99% or higher. Gallstone disease was associated with hemolytic disease in 23% (73/324) of patients and with obesity in 39% (126/324). Logistic regression demonstrated older age (P = .019) and Hispanic ethnicity (P < .0001) as independent risk factors for nonhemolytic gallstone disease. Compared with our historical series, children undergoing cholecystectomy are more likely to be Hispanic (P = .003) and severely obese (P < .0279).
  
  
  CONCLUSIONS
  Obesity and Hispanic ethnicity are strongly correlated with symptomatic pediatric gallbladder disease. In comparison with our historical series, hemolytic disease is no longer the predominant risk factor for symptomatic gallstone disease in children.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, Texas Children’s Hospital, Houston, Texas, USA. seemam@bcm.edu
authors.forename: Seema
authors.initials: S
authors.lastname: Mehta
authors.forename: Monica E
authors.initials: ME
authors.lastname: Lopez
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Chumpitazi
authors.forename: Mark V
authors.initials: MV
authors.lastname: Mazziotti
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Fishman
mesh_terms: D000293:Adolescent; D000743:Anemia, Hemolytic / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy; D005260:Female; D005705:Gallbladder Diseases / Q000208:ethnology / Q000209:etiology* / Q000601:surgery; D042882:Gallstones / Q000208:ethnology / Q000209:etiology / Q000601:surgery; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications; D012307:Risk Factors