Gallbladder disease in childhood
H. Takiff and E. W. Fonkalsrud
Seventy-seven children less than 19 years old underwent cholecystectomy
during a 12-year period at UCLA Medical Center. Forty-four had calculous
cholecystitis; five had acalculous cholecystitis; and 28 underwent
cholecystectomy with other major biliary surgery. In more than half of the
patients with calculous cholecystitis, a cause for cholelithiasis could be
identified, most commonly total parental nutrition use. Those without an
identifiable etiology were all females, were older, were generally obese,
had a family history of gallbladder disease and had a higher likelihood of
adult-life symptomatology. Cholelithiasis was best demonstrated by
ultrasound and oral cholecystogram. Children with biliary atresia,
choledochal cysts and other anomalies of the extrahepatic biliary system
will benefit from cholecystectomy associated with reconstruction of the
ductal system. Mortality and low morbidity were not related to
cholecystectomy.
