Pediatric Cholecystectomy: Clinical Significance of Cases Unrelated to Hematologic Disorders
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent chol-ecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by com-paring a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group.Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was 21.7 kg/m2, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of over-weight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy.Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.
Abstract
Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent chol-ecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by com-paring a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group.Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was 21.7 kg/m2, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of over-weight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy.Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.
참고문헌 (35)
- Bailey PV, "Changing spectrum of cholelithiasis and cholecystitis in infants and children", Am J Surg, 158, pp.585~588 (1989)
- Kang JY, "Gallstones--an increasing problem:a study of hospital admissions in England between 1989", 1990 and 1999, Aliment Pharmacol Ther, pp.2003 (2000), 17[DOI]
- Kratzer W, "Prevalence of gallstones in sonographic surveys worldwide", J Clin Ultrasound, 27, pp.1~7 (1999)
- Balaguer EJ, "National trends in the utilization of cholecystectomy in children", J Surg Res, 134, pp.68~73 (2006)
- Mehta S, "Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease", Pediatrics, 129, pp.e82~88 (2012)
- Waldhausen JH, "Cholecystectomy is becoming an increasingly common operation in children", Am J Surg, 177, pp.364~367 (1999)
- Kaye AJ, "Use of laparoscopic cholecystectomy for biliary dyskinesia in the child", J Pediatr Surg, 43, pp.1057~1059 (2008)
- Hofeldt M, "Laparoscopic cholecystectomy for treatment of biliary dyskinesia is safe and effective in the pediatric population", Am Surg, 74, pp.1069~1072 (2008)
- Al-Homaidhi HS, "Biliary dyskinesia in children", Pediatr Surg Int, 18, pp.357~360 (2002)
- Whitington PF, "Cholelithiasis in premature infants treated with parenteral nutrition and furosemide", J Pediatr, 97, pp.647~649 (1980)
- Roslyn JJ, "Increased risk of gallstones in children receiving total parenteral nutrition", Pediatrics, 71, pp.784~789 (1983)
- Shaffer EA, "Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?", Curr Gastroenterol Rep, 7, pp.132~140 (2005)
- Skelton JA, "Prevalence and trends of severe obesity among US children and adolescents", Acad Pediatr, 9, pp.322~329 (2009)
- Al-Salem AH, "The significance of biliary sludge in children with sickle cell disease", Pediatr Surg Int, 13, pp.14~16 (1998)
- Wesdorp I, "Clinical presentations and predisposing factors of cholelithiasis and sludge in children", J Pediatr Gastroenterol Nutr, 31, pp.411~417 (2000)
- Palasciano G, "Gallstone prevalence and gallbladder volume in children and adolescents: an epidemiological ultrasonographic survey and relationship to body mass index", Am J Gastroenterol, 84, pp.1378~1382 (1989)
- Nomura H, "Prevalence of gallstone disease in a general population of Okinawa, Japan", Am J Epidemiol, 128, pp.598~605 (1988)
- Angelico F, "Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO)", Ital J Gastroenterol Hepatol, 29, pp.249~254 (1997)
- Zubler J, "Natural history of asymptomatic gallstones in family practice office practices", Arch Fam Med, 7, pp.230~233 (1998)
- Attili AF, "The natural history of gallstones: the GREPCO experience. The GREPCO Group", Hepatology, 21, pp.655~660 (1995)
- Friedman GD, "Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization", J Clin Epidemiol, 42, pp.127~136 (1989)
- McSherry CK, "The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients", Ann Surg, 202, pp.59~63 (1985)
- Miltenburg DM, "Changing indications for pediatric cholecystectomy", Pediatrics, 105, pp.1250~1253 (2000)
- Kumar R, "Gallstones and common bile duct calculi in infancy and childhood", Aust N Z J Surg, 70, pp.188~191 (2000)
- Schweizer P, "Pathogenesis and symptomatology of cholelithiasis in childhood. A prospective study", Dig Surg, 17, pp.459~467 (2000)
- Everhart JE, "Prevalence and ethnic differences in gallbladder disease in the United States", Gastroenterology, 117, pp.632~639 (1999)
- Henschke CI, "Cholelithiasis in children: recent observations", J Ultrasound Med, 2, pp.481~484 (1983)
- Reif S, "Gallstones in children. Characterization by age, etiology, and outcome", Am J Dis Child, 145, pp.105~108 (1991)
- Bogue CO, "Risk factors, complications, and outcomes of gallstones in children: a single-center review", J Pediatr Gastroenterol Nutr, 50, pp.303~308 (2010)
- Khoo AK, "Cholecystectomy in English children: evidence of an epidemic (1997-2012)", J Pediatr Surg, 49, pp.284~288 (2014)
- Holcomb GW Jr, "Cholelithiasis in infants, children, and adolescents", Pediatr Rev, 11, pp.268~274 (1990)
- Ogden CL, "Prevalence of overweight and obesity in the United States, 1999-2004", JAMA, 295, pp.1549~1555 (2006)
- Luo J, "Time trends of obesity in pre-school children in China from 1989 to 1997", Int J Obes Relat Metab Disord, 26, pp.553~558 (2002)
- Varadarajulu S, "Technical outcomes and complications of ERCP in children", Gastrointest Endosc, 60, pp.367~371 (2004)
- Metreweli C, "Magnetic resonance cholangiography in children", Br J Radiol, 77, pp.1059~1064 (2004)
