Management of gallstone pancreatitis in children

Abstract

Gallstone pancreatitis is an increasingly recognized pathology in the pediatric population, and there has been work done in the scientific community to create consensus guidelines regarding management. While historically attributed to hemolytic diseases, cholelithiasis in children is increasingly being attributed to childhood obesity, oral contraceptive pill (OCP) use, and pregnancy. At this time, guidelines are largely based on adult management protocols that are safe and effective in the pediatric population: fluid resuscitation with crystalloid, early enteral feeding, management of choledocholithiasis with endoscopic retrograde cholangiopancreatography (ERCP) with gastroenterology or a “Surgery-first” approach with optional common bile duct exploration at time of cholecystectomy, and cholecystectomy during index admission. However, continued work is needed to create more precise guidelines for the pediatric population.