title: The increasing incidence of gallbladder disease in children: A 20year perspective.
abstract: OBJECTIVE
  The incidence of cholecystectomy in the pediatric population has increased over the last 20years but has not been described in a Canadian population. We conducted the first province-wide study to describe the incidence of cholecystectomy in children in Ontario.
  
  
  METHODS
  A population-based, retrospective cohort using administrative databases in Ontario, Canada, was conducted. We included patients less than 18years of age who underwent cholecystectomy from 1993 to 2012. Trends in rates of cholecystectomy were assessed with the Cochrane-Armitage test.
  
  
  RESULTS
  There were a total of 6040 pediatric cholecystectomies performed over the study period in Ontario. The mean age was 14.3years, and 79.6% of patients were females. The crude incidence per 100,000 person-years increased from 8.8 to 13.0 (p<0.001) from 1993 96-2009-12, respectively. The sex-specific incidence showed a larger increase in the female population from 14.7 to 21.1 per 100,000 person-years (p<0.001). The vast majority (82%) of surgeries were performed in 13-17year olds and were largely performed in the community (>75%).
  
  
  CONCLUSIONS
  There has been a significant rise in the incidence of pediatric cholecystectomy in Ontario over the last 20years. The majority of surgeries are performed in the community, and pediatricians will likely see an increase of gallbladder disease in practice.
authors.affiliation: Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Murphy
authors.affiliation: Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Kelly N
authors.initials: KN
authors.lastname: Vogt
authors.affiliation: Institute for Clinical Evaluative Sciences, London, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Winick-Ng
authors.affiliation: Institute for Clinical Evaluative Sciences, London, ON, Canada.
authors.forename: J Andrew
authors.initials: JA
authors.lastname: McClure
authors.affiliation: Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Institute for Clinical Evaluative Sciences, London, ON, Canada; Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
authors.forename: Blayne
authors.initials: B
authors.lastname: Welk
authors.affiliation: Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Division of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada. Electronic address: Sarah.Jones@lhsc.on.ca.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Cholelithiasis; Gallbladder; Population