Elías Pollina J, Garate J, Martin Bejarano E, Vitoria J C, Sojo A, Ubalde J, Perez Marrodan J A, Olivera J E, Zubillaga P, Fernandez P
Servicio de Cirugía Pediátrica, Hospital Miguel Servet, Zaragoza.
Cir Pediatr. 1992 Apr;5(2):96-100.
Fifty six cases of cholelithiasis in patients aged two months to 15 years (mean age 7.65 years) concerning to 11 hospitals are reviewed. The study protocol followed was the same in all medical records, although own criterions were considered on management performed in each center. From the cases, it follows: 1. Male/female rate is 1/1.5. 2. Symptomatology in infancy is relatively poor and pain localization is not orientative. 3. It was an incidentally finding in 41 per 100 of the cases. 4. Ultrasonography is the best examination procedure rendering diagnosis in the 51 cases it was underwent. 5. Hematologic study was abnormal in six of 46 cases. 6. Medical treatment was not performed in any hospital. 7. Existence of "lithogenic families" seems to be demonstrated. 8. The presence of four patients with Down syndrome in this series must be pointed out. 9. Among total 56 cases, 21 underwent surgical treatment, 29 were conservatively treated, two have died and four patients had spontaneous stone resolution. 10. In the face of these, we propose: A) Surgical treatment in symptomatic cases, porcelain gallbladder and nonfunctionating gallbladder. B) Expectant management and sonographic monitoring in asymptomatic cases. C) Carefully evaluation in patients with predisposing factors and patients with recurrent abdominal pain.
回顾了来自11家医院的56例年龄在2个月至15岁（平均年龄7.65岁）的胆石症患者。尽管每个中心在治疗中都考虑了自身的标准，但所有病历所遵循的研究方案是相同的。从这些病例中得出以下结论：1. 男/女比例为1/1.5。2. 婴儿期的症状相对不明显，疼痛定位不具有指向性。3. 每100例中有41例是偶然发现。4. 超声检查是最佳检查方法，在接受该检查的51例中做出了诊断。5. 46例中有6例血液学检查异常。6. 没有一家医院进行药物治疗。7. “结石形成家族”的存在似乎得到了证实。8. 必须指出本系列中有4例唐氏综合征患者。9. 在总共56例中，21例接受了手术治疗，29例接受了保守治疗，2例死亡，4例患者结石自行溶解。10. 面对这些情况，我们建议：A）对有症状的病例、瓷胆囊和无功能胆囊进行手术治疗。B）对无症状病例进行观察处理并超声监测。C）对有易感因素的患者和反复腹痛的患者进行仔细评估。
