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World J Gastroenterol. Mar 7, 2008; 14(9): 1383-1388
Published online Mar 7, 2008. doi: 10.3748/wjg.14.1383
Management of cholelithiasis in Italian children: A national multicenter study
Claudia Della Corte, Diego Falchetti, Gabriella Nebbia, Marisa Calacoci, Maria Pastore, Ruggiero Francavilla, Matilde Marcellini, Pietro Vajro, Raffaele Iorio
Claudia Della Corte, Pietro Vajro, Raffaele Iorio, Department of Paediatrics, University of Naples “Federico II”, Via S. Pansini 5, Naples 80131, Italy
Diego Falchetti, Department of Pediatric Surgery, “Spedali Civili”, Piazza Spedali Civili 1, Brescia 25100, Italy
Gabriella Nebbia, Department of Pediatrics II, Fondazione IRCCS Ospedale Maggiore di Milano, Via F. Sforza 35, Milan 20122, Italy
Marisa Calacoci, Department of Pediatrics, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy
Maria Pastore, Department of Pediatrics, IRCCS “Casa Sollievo della Sofferenza”, Viale Cappuccini 1, San Giovanni Rotondo 71013, Italy
Ruggiero Francavilla, Department of Pediatrics, University of Bari, Piazza Giulio Cesare 11, Bari 70124, Italy
Matilde Marcellini, Department of Pediatrics, Ospedale “Bambin Gesù”, Piazza S. Onofrio 4, Rome 00165, Italy
Author contributions: Della Corte C wrote the paper and organized the figures and patient data; Vajro P, Falchetti D, Nebbia G, Colacoci M, Pastore M, Francavilla R and Marcellini M helped organize and correct the paper; Iorio R supervised the writing and organization process.
Correspondence to: Raffaele Iorio, MD, Pediatric Liver Unit, Department of Pediatrics, University Federico II of Naples, Via S. Pansini 5, Naples 80131, Italy. riorio@unina.it
Telephone: +39-81-7464337
Fax: +39-81-5451278
Received: September 21, 2007
Revised: January 3, 2008
Published online: March 7, 2008
Abstract

AIM: To evaluate the management of Italian children with cholelithiasis observed at Pediatric and Surgical Departments linked to Italian Society of Pediatric Gastroenterology Hepatology and Nutrition.

METHODS: One-hundred-eighty children (90 males, median age at diagnosis 7.3 years; range, 0-18 years) with echographic evidence of cholelithiasis were enrolled in the study; the data were collected by an anonymous questionnaire sent to participating centers.

RESULTS: One hundred seventeen patients were treated with ursodeoxycholic acid; in 8 children dissolution of gallstones was observed, but the cholelithiasis recurred in 3 of them. Sixty-five percent of symptomatic children treated became asymptomatic. Sixty-four patients were treated with cholecystectomy and in only 2 cases a postoperative complication was reported. Thirty-four children received no treatment and were followed with clinical and echographic controls; in no case the development of complications was reported.

CONCLUSION: The therapeutic strategies were extremely heterogeneous. Ursodeoxycholic acid was ineffective in dissolution of gallstones but it had a positive effect on the symptoms. Laparoscopic cholecystectomy was confirmed to be an efficacy and safe treatment for pediatric gallstones.

Keywords: Pediatric cholelithiasis; Ursodeoxycholic acid; Laparoscopic cholecystectomy; Gallstones; Children