[KimS]

Whatever that means... I think it means a regular North American diet.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Pediatr Surg Int. 1997 Jul;12(5-6):348-52. Links
Trends in management of gallbladder disorders in children.

* Lugo-Vicente HL.

Section of Pediatric Surgery, Department of Surgery, San Pablo Medical Center, Bayamon, Puerto Rico.

Gallbladder disorders have been recognized with increasing frequency in pediatric patients. This study aimed to identify recent trends in management and compare the effectiveness of laparoscopic (LC) over open cholecystectomy (OC) by a retrospective chart analysis of all cholecystectomies from 1990 through 1995. Information obtained included demographics, symptoms, predisposing conditions, associated illnesses, family history, imaging studies, type of cholecystectomy, complications, operative time, pain medication, diet recommencement, pathologic findings, and length of hospital stay. The type of cholecystectomy (OC vs. LC) was compared with the clinical variables using standard statistics. Eighty-three patients between 21 months and 18 years of age were identified; their mean age was 14.8 years. Females (76%) with classic biliary symptoms predominated;12% of the patients developed gallstone pancreatitis and 7% jaundice. Abnormal liver chemistry values, obesity, and elevated triglyceride levels comprised the most significant predisposing factors. Indications for surgery were cholelithiasis in 71 patients (86%), gallbladder dyskinesia in 10 (12%), and sludge/polyp in 2. Fifty-nine cholecystectomies (71%) were done laparoscopically and 24 (29%) open. Choledocholithiasis in 6 children (7%) was managed by open extraction with t-tube placement or endoscopic papillotomy followed by LC. No major ductal complication was identified. The predominant pathologic finding was chronic cholecystitis, including the subgroup with biliary dyskinesia. Statistical comparison showed that LC is superior to OC in regard to length of stay, diet resumption, use of pain medication, operating time, and cosmetic results. It is concluded that a contemporary diet, obesity, and abnormal liver chemistry are the main predisposing conditions of gallbladder disease in children in this decade. Females in their teenage years with typical symptoms continue to be the most commonly affected group. Persistent biliary symptoms associated with low gallbladder ejection fractions during hepatobiliary cholecystokinin-stimulated scans can be caused by dyskinesia. The method of choice to remove the diseased gallbladder in children is LC, which is safe, efficient, and superior to the conventional method. Common duct stones can be managed by simultaneous endoscopic papillotomy. The costs of LC are reduced by employing reusable equipment and selective cholangiographic indications.

PMID: 9244096 [PubMed - indexed for MEDLINE]

[jccgf]

We have friends whose 1 1/2 year old daughter had to have her gallbladder removed because of gallstones. At the time, I think they thought it might be because she was drinking too much milk (and not much food).

She is the same age as my older daughter is. She developed Hashimoto's thyroiditis in her late teens. She also has Von Willebrand's disease, discovered in pre-op testing as a toddler. And more.

You just always wonder how many things might be related and how many clues are laid out for us along the way, possibly pointing to other underlying problems.

Cara