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Pediatric Cholelithiasis ( Gall stone)

  • What is this disease?

    • The gallbladder is located in right upper abdomen, underneath the liver. It stores bile, which is produced by the liver to help absorb fats in our food. Gallstones( cholelithiasis) are stone-like formations found in the gallbladder. They can vary significantly in size, shape and consistency, and they can be symptomatic or asymptomatic.

  • How it is diagnosed?

    • Cholelithiasis ( gall stones ) are diagnosed based on clinical,  biochemical parameters and confirmed on ultrasonographical examination. Sometimes, in complicated cases, magnetic resonance cholangiopancreatography (MRCP) is also needed.

  • How it is treated?

    • For symptomatic children, surgery is recommended. Treatment of incidentally diagnosed children is controversial and can range from conservative follow up to surgical treatment. In Indian subcontinent, especially in Gangatic belt, because of high incidence of gall bladder cancer, many surgeons recommend cholecystectomy in adolescent children  with gall stones.

  • When it should be operated?

    • Most of the surgeons will like to do the surgery when acute events (pain, vomiting etc. ) has just started(within 72 hours) or after 6-12 weeks of resolution of acute symptoms.

  • Are there other alternative methods of treatment?

    • Surgery is only modality available. Sometimes, medical treatment is tried. However, studies have found it to be not an effective modality of treatment. In most of children, removing the gallbladder means the end of problems associated with gallstones(pain, risk of pancreatitis, risk of gall bladder cancer). It is rare to notice any long term side effects of having the gallbladder removed. Rarely, children notice some looser bowel motions, but commonly this resolves. There is a small increased risk of developing intestinal cancer following gallbladder removal in adults but more research is needed to confirm or rule out whether this risk exists for children.

  • What all I need to know before my child surgery?

    • Read “All you need to know before your child's surgery” information booklet in website.

  • How is the surgery done?

    • The standard surgery , even in children, is Laparoscopic Cholecystectomy. It entails removal of gall Bladder by keyhole, under camera guidance.

  • Remarks

    • For more details of surgery, contact your surgeon

  • Related Photographs and videos

    • Few photographs of steps done by me  is given here for learning purposes. For more details ( for medical professionals) Download

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