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      • Record: found
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      Cholelithiasis and choledocholithiasis in children; risk factors for development

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          Abstract

          Purpose

          To compare anthropometric data (body mass index [BMI]) in patients without lithiasis to patients with symptomatic simple cholelithiasis or choledocholithiasis.

          Methods

          We retrospectively reviewed data from 147 patients undergoing laparoscopic cholecystectomy between 2001–2015. Complete growth data from 98 patients was compared with anthropometric data from the population of the Czech Republic and a control group (BMI of 100 consecutive patients without biliary stones in abdominal ultrasound who were admitted to a surgical department for suspected appendicitis).

          Results

          The BMI of 75 children with simple cholelithiasis and 23 with choledocholithiasis was compared to the standard Czech pediatric population and to the control group. The median age (simple cholelithiasis and choledocholithiasis) was 16 years, and 35 patients (24%) had a family history of gallstones. Types of lithiasis included multiple (n = 120), solitary (n = 11), and sludge (n = 10). Five cases had polyps and one had gallbladder dysplasia. Patients with simple cholelithiasis had significantly higher BMI compared to the control group without cholelithiasis (p<0.0001) and the standard Czech population (p = 0.03). Patients with choledocholithiasis had a mean BMI significantly higher than that of the general population (p = 0.001) and the control group (p = 0.0001). Patients with choledocholithiasis had significantly higher BMI than those with simple cholelithiasis (p = 0.03).

          Conclusion

          Patients with cholelithiasis had significantly higher BMI than the general population, and patients with choledocholithiasis had significantly higher BMI than patients with simple lithiasis. Elevated BMI is a risk factor for developing choledocholithiasis. ERCP and early laparoscopic cholecystectomy in patients with choledocholithiasis offer equivalent outcomes in patients with simple cholelithiasis.

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          Most cited references22

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          EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones.

          (2016)
          Article 0 comments Cited 146 times – based on 0 reviews     Review now
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            Intra-abdominal pressure in the morbidly obese.

            R Armour-Forse, Simon Marceau, Sylvie D. Lambert (2005)
            Recent data suggests that increased intra-abdominal pressure (IAP) is one factor associated with the morbidity of morbidly obese patients, who have a BMI>35 kg/m2. IAP has been proposed to be an abdominal compartment syndrome (ACS). This study investigated the characteristics of IAP in morbidly obese patients. 45 morbidly obese patients (mean BMI55+/-2 kg/m2) had IAP measured using urinary bladder pressure. The mean IAP for the morbidly obese group was 12+/-0.8 cmH2O, increased when compared to controls (IAP=0+/-2 cmH2O). The IAP correlated to the sagittal abdominal diameter, an index of the degree of central obesity (r=+0.83, P<0.02); however, it did not correlate to basal insulin, body weight, or BMI. The end-expiratory IAP did not change when measured after the laparotomy incision was made, but IAP measured in the last 15 patients increased during the first 2 postoperative days. The IAP for patients with pressure-related morbidity (gastroesophageal reflux disease, hernia, stress incontinence, diabetes, hypertension, and venous insufficiency) was 12+/-1 cmH2O, while those without these morbidities had an IAP of 9+/-0.8 cmH2O. We conclude that IAP is increased in morbid obesity. This increased IAP is a function of central obesity and is associated with increased morbidity. The degree of IAP elevation correlates with increased co-morbidities. We also conclude that elevation in IAP in morbid obesity is not a true ACS but represents a direct mass effect of the visceral obesity.
            Article 0 comments Cited 61 times – based on 0 reviews     Review now
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              What is normal intra-abdominal pressure?

              Kenneth S Helmer, P Tenofsky, J M Dort … (2001)
              The causes and effects of increased intra-abdominal pressure and abdominal compartment syndrome have been well documented. However, there have been no large series to determine normal intra-abdominal pressure in hospitalized patients. The purpose of this study was to determine normal intra-abdominal pressure in randomly selected hospitalized patients and to identify factors that predict variation in normal intra-abdominal pressure. A total of 77 patients were prospectively enrolled between September 1998 and July 1999. Data obtained included patient demographics (i.e., age, gender, height, weight, and body mass index), reason for hospitalization and bladder catheterization, previous and current surgical status, comorbidities, and intra-abdominal pressures. Intra-abdominal pressure readings were obtained through an indwelling transurethral bladder (Foley) catheter. Data were analyzed by analysis of variance and multiple regression analysis. There were 36 females and 41 males with a mean age of 67.7 years. Average weight, height, and body mass index were 79.6 kg, 1.70 m, and 27.6 kg/m2, respectively. Mean intraabdominal pressure was 6.5 mm Hg (range 0.2-16.2 mm Hg). Body mass index was positively related to intra-abdominal pressure (P < 0.0004). Gender, age, and medical and surgical histories did not significantly affect intra-abdominal pressure. However, using multiple regression analysis, a relationship between intra-abdominal pressure, body mass index, and abdominal surgery was discovered. Intra-abdominal pressure is related to a patient's body mass index and influenced by recent abdominal surgery. Thus, the normal intra-abdominal pressure can be estimated in hospitalized patients by using the derived equation. Knowledge of the expected intra-abdominal pressure can then by used in recognizing when an abnormally high intra-abdominal pressure or abdominal compartment syndrome exists.
              Article 0 comments Cited 33 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Barbora Frybova: Role: Writing – original draft
                Jiri Drabek: Role: Resources
                Jindra Lochmannova: Role: Resources
                Ladislav Douda: Role: Writing – review & editing
                Stepan Hlava:
                ORCID: http://orcid.org/0000-0001-8004-844X
                Role: Writing – review & editing
                Daniela Zemkova: Role: Resources
                Vladimir Mixa: Role: Resources
                Martin Kyncl: Role: Resources
                Lubos Zeman: Role: InvestigationRole: Resources
                Michal Rygl:
                ORCID: http://orcid.org/0000-0002-4804-039X
                Role: Conceptualization
                Radan Keil: Role: ConceptualizationRole: Writing – review & editing
                Pavel Strnad: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 15 May 2018
                Publication date Collection: 2018
                Volume: 13
                Issue: 5
                Electronic Location Identifier: e0196475
                Affiliations
                [1 ] Department of Pediatric Surgery, Charles University in Prague, 2 nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
                [2 ] Department of Internal Medicine, Charles University in Prague, 2 nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
                [3 ] 2 nd Department of Internal Medicine–Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
                [4 ] Department of Pediatrics, Charles University in Prague, 2 nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
                [5 ] Department of Anaesthesiology and Intensive Care Medicine, Charles University in Prague, 2 nd Faculty of Medicine, University Hospital in Motol in Prague, Prague, Czech Republic
                [6 ] Department of Radiology, Charles University in Prague, 2 nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
                Medizinische Fakultat der RWTH Aachen, GERMANY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8004-844X
                http://orcid.org/0000-0002-4804-039X
                Article
                Publisher ID: PONE-D-17-43062
                DOI: 10.1371/journal.pone.0196475
                PMC ID: 5953441
                PubMed ID: 29763444
                SO-VID: d9c95145-c19a-42ee-ae67-6bd3c30f828c
                Copyright © © 2018 Frybova et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 8 December 2017
                Date accepted : 13 April 2018
                Page count
                Figures: 4, Tables: 3, Pages: 11
                Funding
                This work was supported by Ministry of Health, Czech Republic—conceptual development of research organization, Motol University Hospital, Prague, Czech Republic 00064203, www.mzcr.cz. No funding bodies had any role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Gastroenterology and Hepatology
                Subject: Biliary Disorders
                Subject: Cholelithiasis
                Subject: Biology and Life Sciences
                Subject: Physiology
                Subject: Physiological Parameters
                Subject: Body Weight
                Subject: Body Mass Index
                Subject: Medicine and Health Sciences
                Subject: Physiology
                Subject: Physiological Parameters
                Subject: Body Weight
                Subject: Body Mass Index
                Subject: Biology and Life Sciences
                Subject: Physiology
                Subject: Physiological Parameters
                Subject: Body Weight
                Subject: Obesity
                Subject: Childhood Obesity
                Subject: Medicine and Health Sciences
                Subject: Physiology
                Subject: Physiological Parameters
                Subject: Body Weight
                Subject: Obesity
                Subject: Childhood Obesity
                Subject: Medicine and Health Sciences
                Subject: Surgical and Invasive Medical Procedures
                Subject: Digestive System Procedures
                Subject: Cholecystectomy
                Subject: Laparoscopic Cholecystectomy
                Subject: Medicine and Health Sciences
                Subject: Surgical and Invasive Medical Procedures
                Subject: Laparoscopy
                Subject: Laparoscopic Cholecystectomy
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Liver
                Subject: Biliary System
                Subject: Gallbladder
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Liver
                Subject: Biliary System
                Subject: Gallbladder
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Children
                Subject: People and Places
                Subject: Population Groupings
                Subject: Families
                Subject: Children
                Subject: Medicine and Health Sciences
                Subject: Pediatrics
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Anthropometry
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Anthropometry
                Custom metadata
                Data Availability All relevant data are within the paper and its Supporting Information files.

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                ScienceOpen disciplines: Uncategorized

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