Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 15;13(5):e0196475.
doi: 10.1371/journal.pone.0196475. eCollection 2018.

Cholelithiasis and choledocholithiasis in children; risk factors for development

Barbora Frybova  1 , Jiri Drabek  2 , Jindra Lochmannova  2 , Ladislav Douda  3 , Stepan Hlava  2 , Daniela Zemkova  4 , Vladimir Mixa  5 , Martin Kyncl  6 , Lubos Zeman  1 , Michal Rygl  1 , Radan Keil  2
Affiliations

Cholelithiasis and choledocholithiasis in children; risk factors for development

Barbora Frybova et al. PLoS One. .

Abstract

Purpose: To compare anthropometric data (body mass index [BMI]) in patients without lithiasis to patients with symptomatic simple cholelithiasis or choledocholithiasis.

Methods: We retrospectively reviewed data from 147 patients undergoing laparoscopic cholecystectomy between 2001-2015. Complete growth data from 98 patients was compared with anthropometric data from the population of the Czech Republic and a control group (BMI of 100 consecutive patients without biliary stones in abdominal ultrasound who were admitted to a surgical department for suspected appendicitis).

Results: The BMI of 75 children with simple cholelithiasis and 23 with choledocholithiasis was compared to the standard Czech pediatric population and to the control group. The median age (simple cholelithiasis and choledocholithiasis) was 16 years, and 35 patients (24%) had a family history of gallstones. Types of lithiasis included multiple (n = 120), solitary (n = 11), and sludge (n = 10). Five cases had polyps and one had gallbladder dysplasia. Patients with simple cholelithiasis had significantly higher BMI compared to the control group without cholelithiasis (p<0.0001) and the standard Czech population (p = 0.03). Patients with choledocholithiasis had a mean BMI significantly higher than that of the general population (p = 0.001) and the control group (p = 0.0001). Patients with choledocholithiasis had significantly higher BMI than those with simple cholelithiasis (p = 0.03).

Conclusion: Patients with cholelithiasis had significantly higher BMI than the general population, and patients with choledocholithiasis had significantly higher BMI than patients with simple lithiasis. Elevated BMI is a risk factor for developing choledocholithiasis. ERCP and early laparoscopic cholecystectomy in patients with choledocholithiasis offer equivalent outcomes in patients with simple cholelithiasis.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
X-ray during ERCP showing choledocholithiasis (X1) and dilatation of the choledochal duct (X2).
Fig 2
Fig 2. Age range of the operated patients.
Fig 3
Fig 3. Comparison of the BMI of patients with simple cholelithiasis who did not undergo ERCP (ERCP 0) with that of the control group.
Fig 4
Fig 4. Comparison of the BMI of patients with choledocholithiasis who underwent the ERCP procedure (ERCP 1) with that of the control group.
See this image and copyright information in PMC

References

    1. Bălănescu RN, Bălănescu L, Drăgan G, Moga A., & Caragaåã R. Biliary lithiasis with choledocolithiasis in children. Chirurgia (Bucur). 2015;110(6):559–61 - PubMed
    1. Pastucha D., Talafa V., Malincikova J., Cihalik C., Hyjanek J., Horakova D. et al. Obesity, hypertension and insulin resistance in childhood–a pilot study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010; 154(1):77–82. - PubMed
    1. Jeanty C., Derderian S. C., Courtier J., & Hirose S. Clinical management of infantile cholelithiasis, J Pediatr Surg. 2015;50(8):1289–92. doi: 10.1016/j.jpedsurg.2014.10.051 - DOI - PubMed
    1. Marcia L. Buck,: Use of Ursodiol in Infants and Children, Pediatric Pharmacotherapy, volume 15, number 2, February 2009
    1. Lammert F., Acalovschi M., Ercolani G., van Erpecum K. J., Gurusamy K., van Laarhoven C. J. et al.: EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. Journal of Hepatology. 2016;65:146–181 doi: 10.1016/j.jhep.2016.03.005 - DOI - PubMed

Publication types

MeSH terms