Treatment strategies for pediatric gallstone disease: a systematic review

Česká verzia

Authors: I. Shahramian ¹ ; A. Aminisefat ² ; M. Tahani ² ; F. Ziyaee ¹ ; A. Mansouri ² ; G. R. Sivandzadeh ³
Authors place of work: Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran ¹; Pediatric Digestive and Hepatic Diseases Research Center, Zabol University of Medical Sciences, Zabol, Iran ²; Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ³
Published in the journal: Gastroent Hepatol 2025; 79(6): 458-464
Category: Dětská gastroenterologie a hepatologie: kazuistika
doi: https://doi.org/10.48095/ccgh2025458

Summary

Background: Pediatric gallstone disease presents unique management challenges. This systematic review analyzes current treatment strategies in children under 18 years of age. Methods: We conducted a literature search (2015–2025) in PubMed, EMBASE, and the Cochrane Library for studies involving pediatric gallstone patients treated with ursodeoxycholic acid (UDCA), laparoscopic cholecystectomy (LC), endoscopic retrograde cholangiopancreatography (ERCP), and laparoscopic common bile duct exploration (LCBDE). Results: Across 758 pediatric cases from 10 studies, LC combined with ERCP showed high efficacy and low complication rates. LCBDE was effective but carried a potentially higher risk of complications. UDCA treatment demonstrated limited success and frequent recurrence. The overall surgical complication rate was 4.7%. Treatment outcomes were influenced by patient-specific factors (e. g., underlying disease, hydration status, and obesity) and proceduralist expertise. Conclusions: LC combined with ERCP appears to be a highly effective intervention for gallstones in children. LCBDE is a viable alternative, although it may be associated with greater complication risk. UDCA is not recommended as a primary treatment based on suboptimal long-term outcomes. Further large-scale, multicenter studies are essential to refine pediatric gallstone management.

Keywords:

gallstones – cholelithiasis – choledocholithiasis – treatment – management – child – infants

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