Jordão Karyne Sumico de Lima Uyeno, Silva Matheus Guedes da, Hessel Gabriel, Yamada Roberto Massao, Bustorff-Silva Joaquim Murray, Bellomo-Brandão Maria Ângela
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brasil.
Arq Gastroenterol. 2025 Feb 17;62:e24048. doi: 10.1590/S0004-2803.24612024-048. eCollection 2025.
Cholelithiasis, characterized by hardened deposits in the gallbladder, presents symptoms such as abdominal pain, jaundice, nausea, and potential complications like cholecystitis and choledocholithiasis. Despite increasing diagnoses, literature on pediatric cholelithiasis is limited, with undefined protocols.
This study aims to evaluate the clinical, laboratory characteristics, and outcomes of pediatric cholelithiasis cases, identifying factors associated with cholecystectomy.
A retrospective case series study was conducted on patients treated at a tertiary service, diagnosed with cholelithiasis via ultrasound from 2007 to 2021. Clinical profiles, comorbidities, examinations, procedures, and patient evolution were assessed. Patients were categorized into two groups: Group NC (no cholecystectomy) and Group C (cholecystectomy).
Thirty-five patients were included, with 51% females and 60% having comorbidities with abdominal pain was the predominant symptom. Thirty-three patients were managed outpatient while two patients continued follow-up at another facility. Twelve opted for expectant management (Group NC), while 21 underwent cholecystectomy (Group C). Elective laparoscopic cholecystectomy was performed in Group C, with a median age of 11 years and 3 months. Group C showed a higher frequency of abdominal pain compared to Group NC, and this difference was significant (P=0.04). No differences were observed in gender, comorbidities, jaundice, fever, laboratory findings, symptom duration, follow-up time, or age at diagnosis. The median follow-up duration in Group NC was 1 year and 7 months.
Abdominal pain was the predominant symptom in patients undergoing cholecystectomy, while comorbidities and laboratory abnormalities showed no significant associations. Although surgical intervention is typically recommended, expectant management proved viable in select cases without ensuing complications during the evaluation period.
胆结石以胆囊内出现硬化沉积物为特征，会引发腹痛、黄疸、恶心等症状以及胆囊炎和胆总管结石等潜在并发症。尽管胆结石的诊断病例不断增加，但有关小儿胆结石的文献有限，且尚无明确的诊疗方案。
本研究旨在评估小儿胆结石病例的临床、实验室特征及治疗结果，确定与胆囊切除术相关的因素。
对一家三级医疗机构在2007年至2021年期间经超声诊断为胆结石的患者进行回顾性病例系列研究。评估患者的临床资料、合并症、检查、治疗过程及病情发展。将患者分为两组：非胆囊切除术组（NC组）和胆囊切除术组（C组）。
共纳入35例患者，其中女性占51%，60%有合并症，主要症状为腹痛。33例患者在门诊接受治疗，2例患者在另一家机构继续随访。12例选择观察等待治疗（NC组），21例接受了胆囊切除术（C组）。C组接受了择期腹腔镜胆囊切除术，中位年龄为11岁3个月。与NC组相比，C组腹痛发生率更高，且差异有统计学意义（P = 0.04）。在性别、合并症、黄疸、发热、实验室检查结果、症状持续时间、随访时间或诊断时年龄方面未观察到差异。NC组的中位随访时间为1年7个月。
腹痛是接受胆囊切除术患者的主要症状，而合并症和实验室异常无明显关联。尽管通常建议进行手术干预，但在评估期间，观察等待治疗在某些未出现并发症的病例中被证明是可行的。
