EN
TÜRKÇE
Poster - 177
Gallstone disease in children and adolescents: A 20-Year retrospective review of incidence, complications, and surgical trends
Zeenat Bhikhoo, Karen Milford, Olga Bednarek, Nicole Acupinpin, Matthew Laaper
IWK Health Centre, Halifax, Nova Scotia, Canada
Purpose:
This study aimed to evaluate the incidence and complexity of pediatric gallstone disease (GD) at the only dedicated Paediatric Surgical service for the provinces of Nova Scotia, New Brunswick and Prince Edward Island over a 20-year period; to assess complication rates, and review surgical practices and associated risk factors.
Methods:
A retrospective cohort study was conducted from 2002 to 2021, including all patients aged 0–18 years presenting with gallstone disease to a single centre. Data analyzed included disease incidence (calculated using census data), rates of uncomplicated gallstone disease (UGD) vs complicated gallstone disease (CGD) (defined as cholecystitis, gallstone pancreatitis, cholangitis, gallstone ileus or Mirizzi syndrome), surgical approaches, risk factors, postoperative outcomes, and the need for additional procedures.
Results:
Two hundred seventy nine patients were included. Mean age at presentation was 12.28 +/- 4 years. Disease incidence remained constant, but there was a trend to an increase in the absolute number of patients presenting with GD. Fifty one (18.27%) patients had cholecystitis at the time of initial presentation, 18 (6.45%) had gallstone pancreatitis, and 43(15.41%) had choledocholithiasis. Two hundred nineteen (78%) patients underwent cholecystectomy, 92% of which were completed laparoscopically. Additional procedures included ERCP, CBD exploration, sphincterotomy, biliary stenting, hepaticojejunostomy and cholangiogram. 31.1% of patients were overweight (n = 87), which did not correlate significantly with CGD (p=0.8).
Conclusion:
Consistent with global trends, the number of patients presenting with GD at our centre has risen in the last two decades, whilst true incidence has remained constant. Health care systems serving areas with growing populations need to adapt to accommodate increasing patient numbers. A number of patients with GD are overweight, but in our series this does not correlate with more complicated disease.