Pediatric acute cholecystitis: Risk factors and outcomes

Figure 1 Clinical characteristics of gall bladder pathology in the pediatric population. A: Sex distribution. The sex distribution among the 12750 pediatric patients undergoing cholecystectomy demonstrated a significant female predominance, with 74.8% of the cohort identifying as female (9530 cases), 25.2% male (3208 cases), and 0.01% non-binary (12 cases), suggesting a gender-based disparity in disease incidence; B: Body mass index classification. Among the 12750 pediatric patients who underwent cholecystectomy, 4628 were classified as obese, 2711 as overweight, 3280 as normal weight, and 2131 as underweight. 58% of the patients were either overweight or obese, establishing a strong association between elevated body mass index and pediatric gallbladder disease; C: Laboratory abnormalities (white blood cell and bilirubin). Elevated white blood cell was present in 62% of patients, while 20% had hyperbilirubinemia, with subcategories of mild (12.7%), moderate (4.2%), and severe (3.5%) elevations. These values correlated with more invasive biliary interventions; D: Surgical approach breakdown. Laparoscopic cholecystectomy was performed in 10710 cases. Cholecystectomy with cholangiography in 2040 cases, common bile duct exploration in 1785 cases, sphincterotomy/sphincteroplasty in 765 cases, and open surgery in 128 cases, highlighting the predominance of minimally invasive techniques; E: Kaplan-Meier discharge survival curve. Over 85% of patients were discharged within the first two days. The curve plateaus for patients with delayed surgery or complications, emphasizing the benefit of early intervention. BMI: Body mass index; WBC: White blood cell; CBD: Common bile duct.