title: Risk factors, complications and outcome of cholelithiasis in children: A retrospective, single-centre review.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical presentation, risk factors, complications, treatment and outcomes of cholelithiasis in children.
  
  
  METHODS
  Children with cholelithiasis were reviewed for demographic information, predisposing factors, presenting symptoms, laboratory findings, complications, treatment and outcome, retrospectively.
  
  
  RESULTS
  A total of 254 children with cholelithiasis (mean age: 8.9 ± 5.2 years) were recruited to the study. Girls (52.8%) were significantly older than boys (P < 0.001). Symptomatic patients (59%) were significantly older than asymptomatic patients (P = 0.002). Abdominal pain was the most frequent symptom. No risk factors were identified in 56.6% of the patients. Ceftriaxone (20%) was the most commonly associated risk factor. At presentation, at least one of the following complications was seen in 14.1% of patients: cholecystitis (10.9%), obstructive jaundice (2.7%), pancreatitis (1.96%) and cholangitis (1.2%). There was no relationship between gallstone size and symptoms, aetiological factors and complications. The cholelithiasis dissolution rate was higher in younger children (P = 0.032), in those with biliary sludge (P < 0.0001) and ceftriaxone-related cholelithiasis (P < 0.001). Haemolytic anaemia (P = 0.001) and older age (P = 0.002) were associated with stable stones. Ursodeoxycholic acid was administered to 94.4% of patients at presentation. Twenty-nine patients underwent cholecystectomy, and seven patients underwent endoscopic retrograde cholangiopancreotography. Patients who were symptomatic at presentation had significantly more frequent symptoms at follow-up (P < 0.001) CONCLUSIONS: Dissolution rate of cholelithiasis was higher in younger children, biliary sludge formation and ceftriaxone-related cholelithiasis but lower in older children and haemolytic anaemia-related cholelithiasis.
authors.affiliation: Department of Pediatric Gastroenterology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey. ceytun@yahoo.com.
authors.forename: Ceyda
authors.initials: C
authors.lastname: Tuna Kirsaclioglu
authors.affiliation: Well Child Clinic, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Bahar
authors.initials: B
authors.lastname: Çuhacı Çakır
authors.affiliation: Department of Radiology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Gulsah
authors.initials: G
authors.lastname: Bayram
authors.affiliation: Department of Pediatric Surgery, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akbıyık
authors.affiliation: Department of Pediatric Hematology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Pamir
authors.initials: P
authors.lastname: Işık
authors.affiliation: Department of Pediatric Hematology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tunç
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002769:Cholelithiasis / Q000150:complications* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors
keywords: aetiology; children; cholelithiasis; treatment