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小儿胆囊切除术:与血液系统疾病无关病例的临床意义。

Pediatric Cholecystectomy: Clinical Significance of Cases Unrelated to Hematologic Disorders.

作者信息

Kim Hae-Young, Kim Soo-Hong, Cho Yong-Hoon

机构信息

Division of Pediatric Surgery, Department of Surgery, Pusan National University School of Medicine, Yangsan, Korea.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2015 Jun;18(2):115-20. doi: 10.5223/pghn.2015.18.2.115. Epub 2015 Jun 29.

Abstract

PURPOSE

Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease.

METHODS

We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group.

RESULTS

There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was 21.7 kg/m(2), with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy.

CONCLUSION

Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.

摘要

目的

儿童和青少年很少进行胆囊切除术。然而,它与多种病症相关。本研究旨在描述接受与血液系统疾病无关的胆囊切除术的儿科患者的特征,然后通过比较单纯性和复杂性胆囊疾病来探讨其在治疗中的临床意义。

方法

我们回顾了2003年1月至2014年10月期间在一家机构接受胆囊切除术的儿科患者(18岁以下)的病例。研究期间共有143例病例,其中24例被选为研究对象。

结果

男性患者7例(29.2%),女性患者17例(70.8%)。平均年龄为13.1岁,66.6%的患者年龄超过12岁。平均体重为52.7kg,体重指数为21.7kg/m²,41.7%的患者超重或肥胖。我们发现在复杂性疾病中女性占优势且超重或肥胖比例较高。该组患者的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)和胆红素水平也显著升高。大多数患者(87.5%)接受了腹腔镜胆囊切除术。

结论

儿童和青少年很少进行与血液系统疾病无关的疾病的胆囊切除术。一般来说,超重或肥胖的女性患者以及12岁以上的患者,由于多发性胆结石需要进行腹腔镜胆囊切除术。这种情况往往表现为复杂性胆囊疾病,且AST、ALT、ALP和胆红素水平显著升高。

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Laparoscopic cholecystectomy in obese and non-obese children.腹腔镜胆囊切除术在肥胖和非肥胖儿童中的应用。
J Surg Res. 2010 Oct;163(2):299-302. doi: 10.1016/j.jss.2010.03.025. Epub 2010 Apr 7.

本文引用的文献

1
Cholecystectomy in English children: evidence of an epidemic (1997-2012).英国儿童胆囊切除术:一种流行病的证据(1997 - 2012年)
J Pediatr Surg. 2014 Feb;49(2):284-8; discussion 288. doi: 10.1016/j.jpedsurg.2013.11.053. Epub 2013 Nov 18.
4
7
National trends in the utilization of cholecystectomy in children.儿童胆囊切除术的全国使用趋势。
J Surg Res. 2006 Jul;134(1):68-73. doi: 10.1016/j.jss.2006.02.053. Epub 2006 May 2.
10
Magnetic resonance cholangiography in children.儿童磁共振胰胆管造影
Br J Radiol. 2004 Dec;77(924):1059-64. doi: 10.1259/bjr/34655158.

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