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
1  Department of Pediatric Surgery, Hôpital des Enfants, Toulouse, France
,
Aurélien Binet
2  Department of Pediatric Surgery, CHU Tours, Tours, France
,
François Varlet
3  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Rhône-Alpes, France
,
Manon Baudry
4  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France
,
Rémi Dubois
5  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France
,
Géraldine Héry
6  Department of Pediatric Surgery, CHU Marseille, Marseille, France
,
Guillaume Podevin
7  Department of Pediatric Surgery, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
,
Olivier Abbo
8  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France
,
Alexis Arnaud
9  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Rennes, Rennes, Bretagne, France
,
Marc Barras
10  Department of Pediatric Surgery, CHRU de Brest, Brest, Bretagne, France
,
Florent Guerin
11  Department of Pediatric Surgery, Hopital Bicetre, Le Kremlin-Bicetre, Île-de-France, France
,
Olivier Reinberg
12  Department of Pediatric Surgery, Bibliotheque Cantonale et Universitaire Lausanne, Lausanne, Switzerland
,
Christian Piolat
13  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Grenoble, Grenoble, Rhône-Alpes, France
,
Laurent Fourcade
4  Department of Pediatric Surgery, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France
› Author Affiliations
Further Information

Publication History

17 April 2017

28 May 2017

Publication Date:
02 July 2017 (eFirst)

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.