Aggiornamento
Calcolosi biliare: non solo per adulti...
Gallstone: not only an adult “affaire”…
Gloria Rossi1, Francesco Cirillo2, Marco Sciveres2, Silvia Riva2, Calogero Ricotta3, Marco Sspada3,4, Giuseppe Maggiore1
1Gastroenterologia Pediatrica, Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa e Dipartimento Materno-Infantile, Azienda Ospedaliera Universitaria Pisana, Pisa
2Epatologia Pediatrica e Trapianto di Fegato, 3Unità dei Trapianti e Chirurgia Addominale, Dipartimento per la Cura e lo Studio delle Patologie Addominali-ISMETT, University of Pittsburg Medical Center, Palermo
4Department of Surgery, University of Pittsburgh, USA
Ottobre 2015 - pagg. 495 -503
Abstract
In recent years cholelithiasis has been on the rise among infants and children, partly
because of improved diagnostic modalities, but also because of an increased awareness
of emerging comorbidities, such as childhood obesity, and other associated risk
factors. Pigment stones are the commonest type of gallstones in children, without recognizable
predisposing factors in infants or secondary to a predisposing disease such
as chronic hemolysis and ileal disease. In adolescents, idiopathic cholesterol gallstones
account for the majority, just like in adults. Gallbladder stones are found in 80%
to 90% of cases and common bile duct stones in 10% to 20% of cases. When common
bile duct stones are found, a choledocal cyst with anomalous pancreatobiliary
duct junction needs to be excluded. Cholecystectomy is not indicated for silent gallstones,
except in children with a predisposing disease such as chronic haemolysis. Treatment
of common bile duct stones includes interventional radiologic, endoscopic or surgical
procedures. In children without a predisposing disease or no residual gallstones
indicating a cholecystectomy, conservative management may be proposed in specialised
centres, especially for infants.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
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Corrispondenza: giuseppe.maggiore@med.unipi.it