title: The impact of age and sex adjusted body mass index (ISO-BMI) in obese versus non-obese children and adolescents with cholecystectomy.
abstract: BACKGROUND
  The impact of the age and sex adjusted body mass index (ISO-BMI) in the obese vs. non-obese children and adolescents with cholecystectomy for cholelithias is rarely reported.
  
  
  METHODS
  The national database was searched for cholecystectomies performed in paediatric patients between 1997 and 2011, and the 59 paediatric and adolescent patients having cholecystectomy in the Kuopio University Hospital district were divided in two groups by age and sex adjusted BMI (ISO-BMI) using the cut-off point of overweight (ISO-BMI 25 kg/m(2)) based on the Finnish growth standards.
  
  
  RESULTS
  Nationwide a total of 840 cholecystectomies were performed during the 15 years study period in Finland, most of which included females (77%), resulting in a mean of annual frequency of 4.8 (range: 3.9-6.1) procedures/100,000 population. In the study sample, most of the patients with the cholelithiasis were female (50/59, 85%). The gender distribution was equal among the younger patients, but among adolescents 6/52 (12%) of the patients with cholelithiasis were boys and 46/52 (88%) of the patients with cholelithiasis were girls. Obesity did not affect on operative parameters. The median operative time was 70 min (range, 30-155) and 66 min (44-130) in the high ISO-BMI-group. The recovery was similar in the two groups: the median length of hospital stay was 4 days in both groups. The patients in the low ISO-BMI-group vs. high ISO-BMI-group had a trend of higher serum bilirubin (p=0.16) and serum AFOS values (p=0.19). In the histological examination of the gallbladders 19/28 (68%) patients in the low ISO-BMI-group had inflammation vs. 26/31 (84%) patients in the high ISO-BMI-group (p=0.15).
  
  
  CONCLUSIONS
  Our results between obese and non-obese children and adolescents with cholelithiasis are not statistically significant. The obese adolescents with female gender are in greater risk for cholelithiasis.
authors: Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors: Eveliina
authors: E
authors: Kiuru
authors: Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors: Hannu
authors: H
authors: Kokki
authors: Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors: Petri
authors: P
authors: Juvonen
authors: Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors: Hannu
authors: H
authors: Lintula
authors: Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors: Hannu
authors: H
authors: Paajanen
authors: National Institute for Health and Welfare, Helsinki, Finland Nordic School of Public Health, Gothenburg, Sweden.
authors: Mika
authors: M
authors: Gissler
authors: Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland matti.eskelinen@kuh.fi.
authors: Matti
authors: M
authors: Eskelinen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005387:Finland / Q000453:epidemiology; D042882:Gallstones / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors
keywords: Cholelithiasis; ISO-BMI; adolescents; cholecystectomy; obesity