From the Hiram C. Polk, Jr., M.D. Department of Surgery, Division of Pediatric Surgery, University of Louisville, Louisville, KY.
Surgery. 2013 Oct;154(4):927-31; discussion 931-3. doi: 10.1016/j.surg.2013.04.040.
The spectrum of pediatric biliary tract disease is changing. The goal of this study was to examine the causes and comorbidities of pediatric gallbladder disease at our institution.
We performed a retrospective chart review on consecutive patient at Kosair Children's Hospital who underwent cholecystectomy over a 9-year time period ending in 2012.
Among the 453 patients in the study group, the average age was 13.3 years and 67.2% were female. Indications for cholecystectomy were gallstones in 285 (63%) and biliary dyskinesia in 140 (33%). Of the patients with gallstones, 68 children (15%) had hemolytic disease. Although the number of cholecystectomies for hemolytic disease was relatively stable throughout our study, the number for biliary dyskinesia and non-hemolytic (cholesterol) cholelithiasis rose by 63% and 216%, respectively. Average body mass index (BMI) for patients with non-hemolytic (cholesterol) stones and biliary dyskinesia were significantly greater than the average BMI for patients with hemolytic stones (P < .0001). In addition, the average BMI for children with non-hemolytic (cholesterol) stones was greater than the average BMI with biliary dyskinesia (P < .0001).
Symptomatic gallbladder disease increased over the study period. Biliary dyskinesia and children with non-hemolytic disease are responsible for this increase.
小儿胆道疾病的谱正在发生变化。本研究的目的是检查我院小儿胆囊疾病的病因和合并症。
我们对 2012 年结束前在 Kosair 儿童医院接受胆囊切除术的连续患者进行了回顾性图表审查。
在研究组的 453 名患者中，平均年龄为 13.3 岁，女性占 67.2%。胆囊切除术的指征是胆结石 285 例（63%）和胆汁运动障碍 140 例（33%）。在有胆结石的患者中，有 68 名儿童（15%）患有溶血性疾病。尽管我们的研究中溶血性疾病的胆囊切除术数量相对稳定，但胆汁运动障碍和非溶血性（胆固醇）胆石症的数量分别增加了 63%和 216%。非溶血性（胆固醇）结石和胆汁运动障碍患者的平均体重指数（BMI）明显大于溶血性结石患者的平均 BMI（P <.0001）。此外，非溶血性（胆固醇）结石患儿的平均 BMI 大于胆汁运动障碍患儿的平均 BMI（P <.0001）。
在研究期间，有症状的胆囊疾病有所增加。胆汁运动障碍和非溶血性疾病是导致这种增加的原因。
