Gallstones

An increasingly recognized and common problem in children, adolescents, and young adults is the formation of gallstones within the gallbladder. At WakeMed, children as young as three months have been diagnosed and treated for this condition.

The Gallbladder

The gallbladder is a digestive organ attached to the undersurface of the liver in the upper part of the abdominal cavity. Its function is to store bile, a dark green fluid produced by the liver, and secrete the bile into the intestine to help digest and absorb fats after meals. Normally, bile remains as a liquid and causes no problems. However, in some cases, solid crystals can form, enlarge and form stones.

Conditions of the Gallbladder

Many patients with gallstones (cholelithiasis) remain asymptomatic for months or even years. Some stones can lodge in the neck of the gallbladder and block its ability to squeeze bile into the intestine. This blockage causes brief attacks of sharp upper abdominal pain with nausea called "biliary colic." Some patients develop so many attacks of biliary colic that they develop chronic scarring of the gallbladder, termed chronic cholecystitis. Others may develop gallbladder infections called acute cholecystitis. Still others may pass their gallstones into the bile duct system, causing transient blockage of the pancreas and inflammation, known as pancreatitis.

High-risk Children

Children at highest risk for gallstone disease include those who:

• Have excess red blood cell breakdown (such as sickle cell anemia and another hemoglobin disorder)
• Have a strong positive family history of gallstone disease
• Are part of certain ethnic groups (such as Latinos/Hispanics)
• Are mildly or moderately obesity

Treatment Options

Almost all children with gallstones will require gallbladder removal. If only the stones themselves are removed, the defective gallbladder will eventually cause the formation of additional stones in the future.

Laparoscopic Gallbladder Removal

Since the late 1980s, most gallbladder surgery has been done using minimally invasive techniques. A small telescope is inserted through the umbilicus (navel or belly button) and then, using several small instruments, the gallbladder can be freed from the liver and bile duct system, and removed. Most children begin eating the same day as the procedure and are discharged in less than 24 hours.

Additional Information

Learn more about Cholecystectomies from the American Pediatric Surgical Association.

Learn What to Expect from Laparoscopic Gallbladder Removal