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Difficult gall bladder in adolescents with cystic fibrosis and symptomatic cholelithiasis: What is the best treatment choice?

  • Author Footnotes
    1 ORCID n°: Dr Boscarelli 0000-0003-1934-1764;
    Alessandro Boscarelli
    Correspondence
    Corresponding author at: Department of Pediatric Surgery and Urology, Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, via dell'Istria, 65/1, 34137 Trieste (TS), Italy.
    Footnotes
    1 ORCID n°: Dr Boscarelli 0000-0003-1934-1764;
    Affiliations
    Department of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
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  • Author Footnotes
    2 ORCID n°: Dr Schleef 0000-0001-9754-2479
    Jürgen Schleef
    Footnotes
    2 ORCID n°: Dr Schleef 0000-0001-9754-2479
    Affiliations
    Department of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy

    Chief of Surgical Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
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  • Author Footnotes
    1 ORCID n°: Dr Boscarelli 0000-0003-1934-1764;
    2 ORCID n°: Dr Schleef 0000-0001-9754-2479
      Gallbladder disease (GBD) has become increasingly common in children. Established risk factors for GBD in childhood include hemolytic disease; ileal resections; obesity; cystic fibrosis; and the use of parenteral nutrition, ceftriaxone, and oral contraceptives. Notably, patients with cystic fibrosis (CF) face an increased risk of developing a wide range of CF-related conditions, including a significantly greater odds ratio for conditions such as cholelithiasis [
      • Miller A.C.
      • Comellas A.P.
      • Hornick D.B.
      • et al.
      Cystic fibrosis carriers are at increased risk for a wide range of cystic fibrosis-related conditions.
      ,
      • Doud A.
      • Bond L.
      • Downard C.
      • et al.
      Management of complicated biliary disease in the pediatric population.
      ]. Furthermore, surgeons should be aware of the high possibility of encountering a difficult gallbladder operation in these patients.

      Abbreviations:

      GBD (gallbladder disease), CF (cystic fibrosis), LC (laparoscopic cholecystectomy), SLC (subtotal laparoscopic cholecystectomy)
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