Cholelithiasis in infancy and childhood: spectrum and current management

ABSTRACT

The advances of imaging studies have led to the recognition of cholelithiasis in infancy and childhood with increasing frequency. This study included 28 children with cholelithiasis managed at the Surgical Departments of Ain-Shams University Hospital, Cairo and Arabian Oil Company Hospital, Saudi Arabia over the past 4 years. Their ages ranged from 1 to 12 years. Twelve children suffered from predisposing disorders, 8 had gall stones in association with hereditary spherocytosis and underwent cholecystectomy during the course of splenectomy while 4 premature babies were treated with total parenteral nutrition [TPN] prior to the diagnosis of cholelithiasis and showed stone resolution within 1 year. Sixteen children had idiopathic gall stones, 12 of them underwent open cholecystectomy [in addition to cyctogastrostomy for pancreatic pseudocyst in one of them], while 4 had laparoscopic cholecystectomy [LC]. Follow-up period ranged from 3 months to 4 years. The importance of nonoperative treatment of childhood cholelithiasis, in selected patients aiming at spontaneous stone resolution and the advantages of applying laparoscopic cholecystectomy [LC] in children, was highlighted