Pediatric gallstone disease, postoperative outcomes, and endoscopic management: a single centre 5-year experience
Bibliographic record
Abstract
Objectives: Pediatric gallstone disease is increasing in incidence, possibly due to rising rates of childhood obesity. There are concerns about delayed presentations and the need for surgery and endoscopic management. The aim of this project is to assess rates of cholecystectomy in pediatrics, distribution of pathology, impact of body mass index (BMI), and need for endoscopic retrograde cholangiopancreatography (ERCP). Methods: percentile) and normal weight cohorts. Results: A total of 210 patients were included with 108 (51.4%) undergoing elective gallbladder surgery, 35 (16.7%) undergoing emergent gallbladder surgery, and 67 (32.0%) requiring surgery for bile duct disease. Most were female (77.3%), overweight (69.9%), and adolescents (mean age 14.0 ± 2.9). Metabolic syndrome-associated steatotic liver disease was present in 5.3%, hereditary spherocytosis in 7.7%, and sickle cell disease in 1.4%. Thirty-eight required ERCP (18.1%). Patients presenting emergently had much longer lengths of stay than did those with elective admissions (median 3.0 ± 3.0 versus 0.0 ± 1.0 days, P < 0.001). Overweight patients more frequently experienced complications than the normal weight cohort (16% versus 7%, P = 0.044). Furthermore, length of stay (LOS) was also higher in the normal weight cohort than in the overweight group in elective biliary colic patients and emergent gallbladder patients (P = 0.007 and 0.042, respectively). Conclusions: Gallstone disease in pediatrics often presents emergently. This is associated with worse outcomes such as prolonged LOS when compared with non-urgent cases. A significant proportion of patients present with common bile duct disease and require ERCP. Early diagnosis leading to surgical referral for patients with gallstone disease and multimodal strategies to decrease risk factors and expedite weight loss may help prevent complicated gallstone disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".