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Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing
Background: Laparoscopic cholecystectomy (LC) is the standard of care for gallbladder (GB) pathologies. We evaluated clinical, ultrasonographic (US) data as well as histopathological findings in children affected with symptomatic cholecystic disease (SCD) who underwent LC, with the aim of defining s...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225274/ https://www.ncbi.nlm.nih.gov/pubmed/32457858 http://dx.doi.org/10.3389/fped.2020.00203 |
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author | Pelizzo, Gloria Bussani, Rossana De Silvestri, Annalisa Di Mitri, Marco Rosone, Gregorio Amoroso, Salvatore Milazzo, Mario Girgenti, Vincenza Mura, Giovanni Battista Unti, Elettra Rozze, Davide Shafiei, Vennus Calcaterra, Valeria |
author_facet | Pelizzo, Gloria Bussani, Rossana De Silvestri, Annalisa Di Mitri, Marco Rosone, Gregorio Amoroso, Salvatore Milazzo, Mario Girgenti, Vincenza Mura, Giovanni Battista Unti, Elettra Rozze, Davide Shafiei, Vennus Calcaterra, Valeria |
author_sort | Pelizzo, Gloria |
collection | PubMed |
description | Background: Laparoscopic cholecystectomy (LC) is the standard of care for gallbladder (GB) pathologies. We evaluated clinical, ultrasonographic (US) data as well as histopathological findings in children affected with symptomatic cholecystic disease (SCD) who underwent LC, with the aim of defining surgical timing. Methods: We reviewed our cases who underwent elective LC (ELC) or urgent LC (ULC). Clinical, US, surgical and histological features were used to create different risk scores. Results: We considered 26 children (17 ELC/9 ULC). US signs were not different in the two groups (p > 0.05). Operating times were longer in ELC than in ULC (p = 0.01). Histopathological evaluation revealed fibrosis and atrophy in both ELC and ULC. The clinical risk score was higher in ELC compared to ULC (p < 0.001). An increased operative risk score was noted in patients with systemic inflammatory signs (OR1.98), lithotherapy (OR1.4.3) and wall thickening ≥3 mm (OR2.6). An increased histopathological risk score was detected in children with symptom duration >7 days (OR3.61), concomitant hematological disease (OR1.23) and lithotherapy (OR3.61). Conclusion: Criteria adopted in adults cannot be adopted to detect the severity of GB damage in children. A dedicated clinical and US score is mandatory to define the most appropriate surgical timing. |
format | Online Article Text |
id | pubmed-7225274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72252742020-05-25 Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing Pelizzo, Gloria Bussani, Rossana De Silvestri, Annalisa Di Mitri, Marco Rosone, Gregorio Amoroso, Salvatore Milazzo, Mario Girgenti, Vincenza Mura, Giovanni Battista Unti, Elettra Rozze, Davide Shafiei, Vennus Calcaterra, Valeria Front Pediatr Pediatrics Background: Laparoscopic cholecystectomy (LC) is the standard of care for gallbladder (GB) pathologies. We evaluated clinical, ultrasonographic (US) data as well as histopathological findings in children affected with symptomatic cholecystic disease (SCD) who underwent LC, with the aim of defining surgical timing. Methods: We reviewed our cases who underwent elective LC (ELC) or urgent LC (ULC). Clinical, US, surgical and histological features were used to create different risk scores. Results: We considered 26 children (17 ELC/9 ULC). US signs were not different in the two groups (p > 0.05). Operating times were longer in ELC than in ULC (p = 0.01). Histopathological evaluation revealed fibrosis and atrophy in both ELC and ULC. The clinical risk score was higher in ELC compared to ULC (p < 0.001). An increased operative risk score was noted in patients with systemic inflammatory signs (OR1.98), lithotherapy (OR1.4.3) and wall thickening ≥3 mm (OR2.6). An increased histopathological risk score was detected in children with symptom duration >7 days (OR3.61), concomitant hematological disease (OR1.23) and lithotherapy (OR3.61). Conclusion: Criteria adopted in adults cannot be adopted to detect the severity of GB damage in children. A dedicated clinical and US score is mandatory to define the most appropriate surgical timing. Frontiers Media S.A. 2020-05-08 /pmc/articles/PMC7225274/ /pubmed/32457858 http://dx.doi.org/10.3389/fped.2020.00203 Text en Copyright © 2020 Pelizzo, Bussani, De Silvestri, Di Mitri, Rosone, Amoroso, Milazzo, Girgenti, Mura, Unti, Rozze, Shafiei and Calcaterra. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Pelizzo, Gloria Bussani, Rossana De Silvestri, Annalisa Di Mitri, Marco Rosone, Gregorio Amoroso, Salvatore Milazzo, Mario Girgenti, Vincenza Mura, Giovanni Battista Unti, Elettra Rozze, Davide Shafiei, Vennus Calcaterra, Valeria Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title | Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title_full | Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title_fullStr | Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title_full_unstemmed | Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title_short | Laparoscopic Cholecystectomy for Symptomatic Cholecystic Disease in Children: Defining Surgical Timing |
title_sort | laparoscopic cholecystectomy for symptomatic cholecystic disease in children: defining surgical timing |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225274/ https://www.ncbi.nlm.nih.gov/pubmed/32457858 http://dx.doi.org/10.3389/fped.2020.00203 |
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