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Childhood cholecystectomy in New Zealand: A multicenter national 10year perspective.

Abstract：

AIM:International studies show increasing incidence of cholelithiasis in childhood and an increasing caseload for the pediatric surgeon. We reviewed pediatric cholecystectomy in all four centers in New Zealand, examining changes in incidence and the demographics of the patient population. METHOD:Coding data were used to retrieve case notes and extract demographic data, diagnosis, comorbidities, length of stay, and complications for patients less than 16years old undergoing cholecystectomy from January 1st, 2004-December 31st, 2013. Patients with congenital biliary malformations were excluded. Statistical analysis was performed using SPSS. RESULTS:170 children required cholecystectomy. On average, 15 procedures were performed annually (IQR 8-24). There was a slight upward trend, with a gradient of 0.34 (P=0.63). Median age was 14 (range 2-15)years, male:female 2:3. While 72% of children were Caucasian, Māori were significantly overrepresented (20%). Numbers of Pacific Islander increased significantly over time (P=0.05), in line with population increases. Of 114 patients with complete dataset, 31% were overweight or obese. Complication rates were 8.8% overall, but 27% of complications occurred in Māori children. 40% of those suffering a complication were obese. Three complications were major, requiring return to theater. Mean length of stay was 5days. CONCLUSIONS:New Zealand has not seen the rapid increase in pediatric cholecystectomy experienced elsewhere in the OECD. However, the problem of adolescent biliary disease is prevalent. The average recipient of a cholecystectomy is 14years old, overweight, and Caucasian; though Māori have a high relative risk of both biliary disease and complicated postoperative course. The reasons for this remain unclear and require further study.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Campbell S,Richardson B,Mishra P,Wong M,Samarakkody U,Beasley S,Pringle K,Morreau P

doi

10.1016/j.jpedsurg.2015.10.071

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

264-7

issue

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(15)00704-6

journal_volume

pub_type

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Childhood cholecystectomy in New Zealand: A multicenter national 10year perspective.