Diseases of the gallbladder in children — modern view of pediatric surgeon (systematic review)

Abstract

Currently, the two main causes of diseases of the gallbladder in children are biliary dyskinesia and the formation of gallbladder stones. Biliary dyskinesia is an independent disease and is caused mainly by reduced motility of the gallbladder, which leads to its insufficiently good emptying and is accompanied by chronic pain abdominal syndrome. The causes of stone formation in children differ from the sources of stone formation in adults. Metabolic disorders, mainly against the background of obesity, lead to the formation of cholesterol stones, which is the most common cause of cholelithiasis in children. Blood diseases is another factor of cholelithiasis associated with hemolysis, such as sickle cell anemia, hereditary spherocytosis, and thalassemia. Symptoms of gallbladder disease are mainly in chronic abdominal pain syndrome. Inflammation of the gallbladder is a fairly rare form of the course of gallstone disease in children. The current surgical technology for treatment of gallbladder diseases in children, as in adults, is cholecystectomy, which can be realized depending on the degree of mastery of endosurgical skills using standard four-port laparoscopic techniques or a single laparoscopic approach. This review addresses the issues of semiotics, etiology, diagnosis, and surgical treatment of gallbladder disease in pediatric patients. The scientific work answers many controversial questions regarding the diagnosis of biliary dyskinesia, the choice of diagnostic method for concomitant choledocholithiasis, and the selection of the most effective surgical approach.