Therapeutic tactics in cholelithiasis in children

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Abstract

There are still many questions concerning the choice of tactics for the treatment of cholelithiasis in childhood. For a long time, cholelithiasis traditionally considered a pathology of adults. Accordingly, virtually all research was devoted to the diagnosis and treatment of this pathology in the above group of patients.

Purpose of research. Justification of tactics in surgical treatment of cholelithiasis in children.

Patients and research methods. The work formed observations on 135 children aged from 2 to 17 years with cholelithiasis. In 70.4% of cases the disease is observed in girls and boys, respectively at 29.6%. 7.8% of patients have children disease arose against the backdrop of hemolytic anemia. One patient, who received urgent indications, had manifestations of mechanical jaundice: an increase in the level of common bilirubin and its direct fraction, pronounced jaundice of the skin. In the second group, 140 children with chronic stoneless cholecystitis were compared.

Research result. All patients with cholelithiasis identified different ways deformation in the area of gallbladder duct. One of the major causes of cholelithiasis in children are changes in the gallbladder duct. No patient has ever been found in concretions extrahepatic biliary passages. In patients with chronic stone-free cholecystitis pathology in the area of bladder flow was not found.

Conclusion. One of the major causes of gallstone disease in children are changes in the gallbladder duct, that most likely leads to obstruction of outflow of bile from the gall bladder, with the subsequent formation of concrements. Therefore, the conduct of conservative treatment of cholelithiasis in children appear to be ineffective and the method of choice in the treatment of this pathology can be a cholecystectomy.

About the authors

Vyacheslav G. Svarich

Public Institution Republican Children’s Clinical Hospital; Pitirim Sorokin Syktyvkar State University

Author for correspondence.
Email: svarich61@mail.ru

Head, Surgical Department; MD, PhD, Dr Med Sci, Professor

Russian Federation, Syktyvkar

Ilya M. Kagantsov

Public Institution Republican Children’s Clinical Hospital; Pitirim Sorokin Syktyvkar State University

Email: ilkagan@rambler.ru

Head, Uronefrological Department; MD, PhD, Dr Med Sci, Professor

Russian Federation, Syktyvkar

Violetta A. Svarich

The Principal Offi ce a Medical Social Examination on the Komi Republic of the Ministry of Labour and Social Protection of the Russian Federation

Email: svarich61@mail.ru

Deputy Director

Russian Federation, Syktyvkar

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Ultrasonic pattern of concretion in the gallbladder

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3. Fig. 2. Gallbladder deformation

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4. Fig. 3. Calcified brupor in the gallbladder

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5. Fig. 4. Ultrasonic pattern of deformed cystic duct

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6. Fig. 5. Intraoperative picture of deformed cystic duct

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Copyright (c) 2020 Svarich V.G., Kagantsov I.M., Svarich V.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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