- 作者：Dominique Debray<sup>1sup><sup> ; sup><sup>dominique.debray@nck.aphp.frsup><sup> ; sup><sup>dominique.debray@gmail.comsup> ; Sté ; phanie Franchi-Abella<sup>2sup> ; Sabine Irtan<sup>3sup> ; Muriel Girard<sup>1sup>
- 刊名：La Presse M¨|dicale
- 出版年：2012
- 期刊代码：pca289_07554982
- 类别：med
- 出版时间：May, 2012
- 卷：41
- 期：5
- 页码：466-473
- 文件大小：440 K
ss="h3">Key points
The prevalence of cholelithiasis is estimated within 0.13%and 2%of children under 19 years of age.Pigment stones are the commonest type of gallstones in <strong class="boldFont">childrenstrong>, without recognizable predisposing factors in infants or secondary to a predisposing disease such as chronic hemolysis and ileal disease in children. In <strong class="boldFont">adolescentsstrong>, idiopathic cholesterol gallstones accounts for the majority, such as in adults.
<strong class="boldFont">Gallbladder stones are found in 80 to 90%of casesstrong> and common bile duct stones in 10 to 20%of cases.
<strong class="boldFont">When common bile duct stones are foundstrong>, a choledocal cyst with anomalous pancreatobiliary duct junction needs to be excluded. Magnetic resonance cholangiopancreatography should be performed in first line.
<strong class="boldFont">Cholecystectomystrong> is not indicated for silent gallstones, except in children with a predisposing disease such as chronic hemolysis.
Treatment of common bile duct stones includes <strong class="boldFont">interventional radiologic, endoscopic or surgical proceduresstrong>. Stone extraction may be performed at endoscopic retrograde cholangiopancreatography with or without sphincterotomy, combined with laparoscopic cholecystectomy. In children without a predisposing disease or no residual gallstones indicating a cholescystectomy, conservative management (percutaneous cholangiography with biliary drainage) may be proposed in specialised centers, especially for infants.
A <strong class="boldFont">hepaticojejunostomystrong> is indicated in cases of choledocal cyst with anomalous pancreatobiliary duct junctions.