Management of Polypoid Gallbladder Lesions in Children: A Multicenter Study

Quentin Ballouhey; Aurélien Binet; François Varlet; Manon Baudry; Rémi Dubois; Géraldine Héry; Guillaume Podevin; Olivier Abbo; Alexis Arnaud; Marc Barras; Florent Guerin; Olivier Reinberg; Christian Piolat; Laurent Fourcade

doi:10.1055/s-0037-1604114

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2018; 28(01): 006-011
DOI: 10.1055/s-0037-1604114

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Management of Polypoid Gallbladder Lesions in Children: A Multicenter Study

Quentin Ballouhey

¹Department of Pediatric Surgery, Hôpital des Enfants, Toulouse, France

,

Aurélien Binet

²Department of Pediatric Surgery, CHU Tours, Tours, France

,

François Varlet

³Department of Pediatric Surgery, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Rhône-Alpes, France

,

Manon Baudry

⁴Department of Pediatric Surgery, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

,

Rémi Dubois

⁵Department of Pediatric Surgery, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France

,

Géraldine Héry

⁶Department of Pediatric Surgery, CHU Marseille, Marseille, France

,

Guillaume Podevin

⁷Department of Pediatric Surgery, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

,

Olivier Abbo

⁸Department of Pediatric Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France

,

Alexis Arnaud

⁹Department of Pediatric Surgery, Centre Hospitalier Universitaire de Rennes, Rennes, Bretagne, France

,

Marc Barras

¹⁰Department of Pediatric Surgery, CHRU de Brest, Brest, Bretagne, France

,

Florent Guerin

¹¹Department of Pediatric Surgery, Hopital Bicetre, Le Kremlin-Bicetre, Île-de-France, France

,

Olivier Reinberg

¹²Department of Pediatric Surgery, Bibliotheque Cantonale et Universitaire Lausanne, Lausanne, Switzerland

,

Christian Piolat

¹³Department of Pediatric Surgery, Centre Hospitalier Universitaire de Grenoble, Grenoble, Rhône-Alpes, France

,

Laurent Fourcade

⁴Department of Pediatric Surgery, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

› Author Affiliations

Abstract

Introduction Polypoid lesions of the gallbladder (PLG) are relatively common in adults, while they are very rare in children. The use of high-quality ultrasonography leads to increased detection of PLG, although less than 20 pediatric cases of primary PLG have been reported in the literature. The aim of this study was to address the experience of PLG management in children.

Materials and Methods A retrospective multicenter review of children with ultrasonographically defined PLG between 2006 and 2016 was performed. The data from 12 pediatric surgery centers were compiled for this purpose.

Results Eighteen patients (mean age: 10.4 ± 4.1 years) were included and managed according to each center's protocols. Cholecystectomy was performed for nine symptomatic patients. Histopathology conclusively revealed four tubular and five papillary adenomas, with a median size of 12 mm (ranging from 3 to 35 mm). Nine asymptomatic children were monitored by sonography over a 24-month (ranging from 12 to 66 months) follow-up period. The median PLG size was 7 mm (ranging from 3 to 9 mm). Two lesions disappeared after 1 and 2 years of follow-up, respectively. None of the patients developed symptoms or malignant transformation.

Conclusion This report confirms appropriate use of a conservative approach with annual clinical and ultrasound follow-up for small-sized and isolated PLG in children given the absence of malignancy and potential vanishing entities. Surgical treatment should be considered in case of lesions larger than 10 mm in size or when they are associated with symptoms.

Keywords

gallbladder - adenomas - ultrasonography - children

Full Text

References

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