Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?
Diez S, Mueller H, Weiss C, Schellerer V, Besendörfer M (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 21
Article Number: 186
Journal Issue: 1
DOI: 10.1186/s12876-021-01772-y
Abstract
Background: In contrast to adults, for whom guidelines on the cholelithiasis treatment exist, there is no consistent treatment of pediatric patients with cholelithiasis throughout national and international departments, most probably due to the lack of evidence-based studies. Methods: We evaluated the German management of pediatric cholelithiasis in a dual approach. Firstly, a retrospective, inter-divisional study was established, comparing diagnostics and therapy of patients of the pediatric surgery department with the management of patients aged < 25 years of the visceral surgery department in our institution over the past ten years. Secondarily, a nation-wide online survey was implemented through the German Society of Pediatric Surgery. Results: Management of pediatric patients with cholelithiasis was primarily performed by pediatricians in the retrospective analysis (p < 0.001). Pediatric complicated cholelithiasis was not managed acutely in the majority of cases with a median time between diagnosis and surgery of 22 days (range 4 days–8 months vs. 3 days in visceral surgery subgroup (range 0 days–10 months), p = 0.003). However, the outcome remained comparable. The hospital’s own results triggered a nation-wide survey with a response rate of 38%. Primary pediatric medical management of patients was confirmed by 36 respondents (71%). In case of acute cholecystitis, 22% of participants perform a cholecystectomy within 24 h after diagnosis. Open questions revealed that complicated cholelithiasis is managed individually. Conclusions: The management of pediatric cholelithiasis differs between various hospitals and between pediatricians and pediatric surgeons. Evidence-based large-scale population studies as well as a common guideline may represent very important tools for treating this increasing diagnosis.
Authors with CRIS profile
Sonja Diez
Department of Paediatric Surgery
Vera Schellerer
Department of Paediatric Surgery
Manuel Besendörfer
Department of Paediatric Surgery
Involved external institutions
Germany (DE)How to cite
APA:
Diez, S., Mueller, H., Weiss, C., Schellerer, V., & Besendörfer, M. (2021). Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? BMC Gastroenterology, 21(1). https://doi.org/10.1186/s12876-021-01772-y
MLA:
Diez, Sonja, et al. "Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?" BMC Gastroenterology 21.1 (2021).
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