CHOLELITHIASIS IN INFANTS – CONSERVATIVE OR SURGICAL TREATMENT?

Abstract

The aim of the research: to optimize the treatment strategy of cholelithiasis in infants by studying the conservative therapy and surgical treatment effectiveness.

Children with cholelithiasis were divided into three groups: 60 children received conservative treatment; 14 children were not treated; 22 children underwent cholecystectomy. Conservative treatment was carried out by administration of Ursofalk suspension (Dr. Falk Farma, Germany) on the daily dose basis – 20 mg/kg of body weight per day once a day – at bedtime. Duration of litholysis ranged from 6 to 24 months. The therapeutic effect was controlled every 3 months by ultrasound examination of the bile ducts and biochemical analysis of blood serum.

Results. Contractile function of the gallbladder normalized after 6 months, biochemical markers of cholestasis after 3 weeks, lipidogram by the end of  the second year of conservative treatment. All children tolerated therapy well. No side effects were found. No spontaneous dissolution of gallstones was observed in 14 children who did not receive litholytic therapy. In 22 children, who underwent surgery, morphological changes in the gallbladder wall were reversible, but most of them formed post-cholecystectomy syndrome. In view of the aforesaid, conservative therapy should be considered the priority method of cholelithiasis treatment in children under 3 years of age. Surgical treatment should be performed only according to vital indications.