Complications of cholelithiasis in children as indications for emergency surgery
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Cholelithiasis in children is a relatively rare disease; however, its incidence is increasing. Consequently, the absolute number of complicated forms may also rise. AIM: The work aimed to analyze the clinical course and outcomes of treatment of uncomplicated and complicated forms of cholelithiasis in children. METHODS: This retrospective study included 53 children treated between 2019 and 2024. Patients were divided into two groups: group 1 comprised 40 children (75.5%) who underwent laparoscopic cholecystectomy for uncomplicated cholelithiasis; group 2 comprised 13 children (24.5%) with complicated cholelithiasis, who, in addition to standard laparoscopic cholecystectomy, underwent various types of common bile duct exploration. RESULTS: The distribution of complications in group 2 was as follows: 4 (30.8%) cases of acute cholecystitis, 2 (15.4%) of acute pancreatitis, 6 (46.1%) of choledocholithiasis, and 1 (7.7%) case of spontaneous perforation of the common bile duct. Types of emergency cholecystectomy in group 2 included: 6 (46.1%) laparoscopic cholecystectomies; 4 (30.8%) cases of laparotomy with cholecystectomy, choledochotomy, choledocholithoextraction, and drainage of the common bile duct through the cystic duct stump; 1 (7.7%) laparotomy with cholecystectomy, choledochotomy, choledocholithoextraction, papillosphincterotomy, and drainage of the common bile duct through the cystic duct stump; and 2 (15.4%) endoscopic retrograde cholangiopancreatographies with papillosphincterotomy followed by delayed laparoscopic cholecystectomy. The median operative time was significantly shorter in group 1 than in group 2: 67.5 [55.0; 85.0] minutes versus 150.0 [85.0; 190.0] minutes, respectively (р=1,0×10–7). The total length of hospital stay after surgery was also significantly shorter in group 1 than in group 2 (p=1,0×10–8). Median values were 3.0 [2.0; 4.0] days in group 1 and 14.0 [12.0; 16.0] days in group 2. CONCLUSION: Diagnosis and treatment of complicated cholelithiasis in children are challenging. Its rarity makes the development of optimal therapeutic approaches particularly demanding. Endoscopic retrograde cholangiopancreatography with papillosphincterotomy is a safe and effective treatment option, though further clinical experience is needed to support its widespread use.
DOI: 10.17816/psaic1920
Authors: Pavel M. Pavlushin, Аleksandra А. Mironova, Aleksei V. Gramzin, Evgenii A. Drobyazgin, Mikhail A. Akselrov, Ivan A. Porshennikov, Gennadii N. Tolstykh, Vladislav N. Tsyganok, Yurii Yu. Koinov, Artem A. Tratonin, Аleksandra А. Okhotina, Artur A. Glazkov, Anna B. Nikulina, Pavel V. Trushin, Yurii V. Chikinev
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415202174