Clinicopathological Concordance of Paediatric Laparoscopic Cholecystectomy at a Single Centre in India

Abstract

Introduction: The overall incidence of cholecystitis in children appears to be increasing although the exact frequency of acute and chronic cholecystitis among children in India or worldwide remains unknown. The frequency of paediatric cholecystitis has proportionally increased with the childhood obesity and intake of habitual fatty food. Aim: To present the histopathological concordance of Laparoscopic Cholecystectomy (LC) performed among children for a clinical diagnosis of Gallbladder (GB) disease. Materials and Methods: A single centre retrospective study was performed including histopathological and relevant clinical data of all paediatric LC performed at Career Institute Of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India, between January 2019 to January 2022. Paediatric patients who had undergone LC in the designated time period for a clinical diagnosis of cholelithiasis and/or inflammatory GB disease with classical signs of inflammation were included. Study population with LC procedure submitted for histological evaluation were identified by performing an electronic search through the archives of Department of Pathology, Career Institute of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India, followed by a manual review of GB specimens, histopathology slides and reports. Results: Among 265 patients who underwent LC during this period, there were 62 (23.4%) children. The average age of presentation was 13 years (range 5-18 years), Forty nine (79%) were girls and 13 (21%) were boys. The clinical diagnosis for which paediatric LCs were performed were cholelithiasis among 51% and cholecystitis among 48%. On histopathological concordance these turned out to be chronic cholecystitis among 98.4% children among which 51% were associated with cholelithiasis. Calculous cholecystitis was more frequent than acalculous cholecystitis. Chronic cholecystitis with cholelithiasis and cholesterolosis was more frequent among adolescent girls. Conclusion: This study suggests that chronic cholecystitis accounts for the majority of inflammatory diseases among children undergoing LC for a GB disease and may or may not be associated with cholelithiasis. Chronic cholecystitis with cholelithiasis and cholesterolosis seem more frequent among adolescent girls.