Clinical Profile, Evaluation and Management of Gallstone Disease in Children in a Rural Referral Tertiary Centre

Abstract

Introduction: Cholelithiasis or gallstone disease is primarily a disease of adults. Recently, there has been a global increase in the incidence in children resulting in an increased number of cholecystectomies both by open technique as well as by laparoscopy at a very young age. Aim: To study the epidemiology and to evaluate the management options and outcomes of cholelithiasis in children from a rural background. Materials and Methods: A prospective study was done on 30 children diagnosed with cholelithiasis in a tertiary care medical college and hospital from April 2014 to April 2016. The data was analysed and evaluated for clinical presentation and management outcomes. Observations were made on the type of surgery (open/laparoscopic cholecystectomy), economical aspects, morbidity and mortality in these patients by descriptive statistics. Results: Amongst the 30 children, males were more commonly affected than females. Children taking a mixed diet (vegetarian and non-vegetarian) had a greater tendency to form gallstones. Laparoscopic cholecystectomy was performed in (n=24, 80%) of cases while (n=6, 20%) cases underwent open cholecystectomy. Mixed stones were common with an incidence of (n=20, 66.6%) while cholesterol stones and pigment stones had an equal incidence of 16.7% in the persent study. No intraperitoneal drainage was done and there were no early or late complications in the present study. Conclusion: Laparoscopic cholecystectomy is a safe, economical and efficacious procedure. It does not have significant morbidity and there is no surgery related mortality.

Keywords

• cholelithiasis
• laparoscopic cholecystectomy
• open cholecystectomy