Paediatric gallstones and laparoscopic cholecystectomy

Abstract

Introduction: Gall stones disease is a rare oc-currence in paediatric patients and the diagno-sis is often overlooked. Patients often present with non-specific symptoms of abdominal pain and the classic features of gallstones are some-times absent [1]. The aim of our study is to in-crease the awareness of cholecystitis and acute pancreatitis being a possible occurrence in the paediatric age group and should therefore be in the differential diagnosis of acute abdominal pain in children. We undertook a retrospective analy- sis of all the paediatric patients recorded as hav- ing had a laparoscopic Cholecystectomy per-formed at Prince Charles Hospital. 8 paediatric patients underwent Laparoscopic cholecysteco- my between 2000 and 2008 consisting of 5 fe-male patients and 3 male patients. The average age of the cohort was 14.1 years [12-16]. Pre- morbid obesity was a feature in 4 patients and all patients reported high fat diet. Abdominal Ul- trasound used to assess all 8 patients who pre- sented with acute abdomen showed gallstones to be present in all. 7 patients underwent an ele- ctive procedure 3-6 months after the initial di-agnosis was made and 1 patient had laparosco- pic Cholecystectomy within 72 hours of initial presentation. 1 patient was found to have an in- herited haematological disorder and 2 of the pa- tients were sisters with a family history of gall- stone disease. 2 patients presented with acute pancreatitis. Gallstone related cholecystitis is a rare occurrence amongst paediatric patients and is often overlooked as a differential diagnosis. We report 8 patients over an 8 year period. Con- clusion: It is important that clinicians include cholecystitis and biliary colic in the differential diagnosis of patients presenting with acute ab-domen in childhood not explained by other di-agnoses. Laparoscopic Cholecystectomy is the treatment of choice and has minimal complica-tions.