The increasing incidence of gallbladder disease in children: a 20 year perspective

Objective — The incidence of cholecystectomy in the pediatric population has increased over the last 20 years but has not been described in a Canadian population. We conducted the first province-wide study to describe the incidence of cholecystectomy in children in Ontario.

Study Design — A population-based, retrospective cohort using administrative databases in Ontario, Canada, was conducted. We included patients less than 18 years of age who underwent cholecystectomy from 1993-2012. Trends in rates of cholecystectomy were assessed with the Cochrane-Armitage test.

Results — There were a total of 6040 pediatric cholecystectomies performed over the study period in Ontario. The mean age was 14.3 years, and 79.6% of patients were females. The crude incidence per 100,000 person-years increased from 8.8 to 13.0 (p < 0.001) from 1993-96 to 2009-12, respectively. The sex-specific incidence showed a larger increase in the female population from 14.7 to 21.1 per 100,000 person-years (p < 0.001). The vast majority (82%) of surgeries were performed in 13-17 year olds and were largely performed in the community (> 75%).

Conclusions — There has been a significant rise in the incidence of pediatric cholecystectomy in Ontario over the last 20 years. The majority of surgeries are performed in the community, and pediatricians will likely see an increase of gallbladder disease in practice.