Etiology and incidence of pediatric gallbladder disease.
OBJECTIVE
The spectrum of pediatric biliary tract disease is changing. The goal of this study was to examine the causes and comorbidities of pediatric gallbladder disease at our institution.


METHODS
We performed a retrospective chart review on consecutive patient at Kosair Children's Hospital who underwent cholecystectomy over a 9-year time period ending in 2012.


RESULTS
Among the 453 patients in the study group, the average age was 13.3 years and 67.2% were female. Indications for cholecystectomy were gallstones in 285 (63%) and biliary dyskinesia in 140 (33%). Of the patients with gallstones, 68 children (15%) had hemolytic disease. Although the number of cholecystectomies for hemolytic disease was relatively stable throughout our study, the number for biliary dyskinesia and non-hemolytic (cholesterol) cholelithiasis rose by 63% and 216%, respectively. Average body mass index (BMI) for patients with non-hemolytic (cholesterol) stones and biliary dyskinesia were significantly greater than the average BMI for patients with hemolytic stones (P < .0001). In addition, the average BMI for children with non-hemolytic (cholesterol) stones was greater than the average BMI with biliary dyskinesia (P < .0001).


CONCLUSIONS
Symptomatic gallbladder disease increased over the study period. Biliary dyskinesia and children with non-hemolytic disease are responsible for this increase.
From the Hiram C. Polk, Jr., M.D. Department of Surgery, Division of Pediatric Surgery, University of Louisville, Louisville, KY.
Sarah K
SK
Walker
Alexandra C
AC
Maki
Robert M
RM
Cannon
David S
DS
Foley
Kristina M
KM
Wilson
Laura A
LA
Galganski
Chad A
CA
Wiesenauer
Sheldon J
SJ
Bond
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007098:Imino Acids; D015994:Incidence; D008297:Male; D012189:Retrospective Studies
D007098:Imino Acids; C008109:iminodiacetic acid