Paediatric cholelithiasis: our experience at a tertiary care centre

Background: With increased incidence of symptomatic and asymptomatic gallstones in children, paediatric cholelithiasis has emerged as an important pathology in children. A retrospective study evaluates paediatric cholelithiasis and its management at a tertiary centre.

Objectives: To study the spectrum of paediatric cholelithiasis and its management issues.

Method: A retrospective study was conducted at a tertiary care on all patients of paediatric cholelithiasis (children less than 14 years) who were managed from April, 2017 to March, 2020. Data regarding demographic profile, clinical history, investigation results, management and postoperative outcomes were collected and analysed.

Results: Of the 52 ultrasound-confirmed cases of gallstones, 35 showed biliary and dyspeptic symptoms; while 17 were asymptomatic. Males outnumbered females; no child less than three years came with gallstones. No definite aetiology was found in 32 cases. Cholecystectomy was done in 40 patients (laparoscopic in 37 cases, open in three cases). Stone analysis revealed mixed stones (thirty cases), pigment stones (eight cases) and pure cholesterol stones (two cases). 10/17 cases of asymptomatic gallstones showed complete stone resolution from gallbladder on follow-up sonogram after six months; 5/17 showed no regression of stones (one symptomatic and rest four underwent elective surgery due to parental anxiety); 2/17 cases were lost to follow up. No major complication was seen.

Conclusions: Of the 52 ultrasound-confirmed cases of gallstones, 32.7% were asymptomatic and 61.5% had no definite aetiology. Of the asymptomatic cases 58.8% showed complete stone resolution from gallbladder on follow-up sonogram after six months

Sri Lanka Journal of Child Health, 2021; 50(2): 286-293