{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:26:58Z","timestamp":1790414818177,"version":"4.1.0"},"reference-count":16,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Cholelithiasis is a rare disease in infants, and there is limited data on its risk factors and management. Objectives: To evaluate the risk factors, management, and response to medical treatment of cholelithiasis in infants. Methods: Infants diagnosed with cholelithiasis by ultrasound between 2018 and 2023 were retrospectively analyzed. Details of patient history, imaging findings, current symptoms, and treatments were reviewed. Results: Over 5 years, 98 infants were diagnosed with cholelithiasis. Thirty-three (33.7%) were girls, and the most common risk factors were the use of cephalosporin antibiotic therapy in 46.9%, sepsis in 30.6%, total parenteral nutrition in 29.6%, prematurity in 27.6%, congenital heart disease in 18.4%, and genetic disease (Down syndrome diagnosis in seven patients) in 16.3%. Only fifteen patients (15.3%) were symptomatic. Ursodeoxycholic acid (UDCA) treatment was given to 90.8% of patients, but nine of them used it for a short period or irregularly, and regular users were 81.6%. Gallstones disappeared in 46 patients (46.9%), including 14 (30.4%) without using UDCA regularly. The response rate to UDCA treatment was lower in preterm infants (p = 0.004). Gallstone resolution was higher in the nonusers, 14\/18 (77.8%) versus 32\/79 (40.5%) (p = 0.03). Acute cholecystitis was observed in only four patients; no other complications were noted. No infant required surgical or endoscopic treatment. Conclusions: UDCA should not be used routinely in children, especially infants, except in symptomatic children with a contraindication to surgery or to reduce clinical symptoms. In the absence of symptoms, patients may be monitored clinically.<\/jats:p>","DOI":"10.3390\/children11121553","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T04:33:29Z","timestamp":1734928409000},"page":"1553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid"],"prefix":"10.3390","volume":"11","author":[{"given":"Sevim","family":"\u00c7akar","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35330, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclin","family":"Eren","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cahit Bar\u0131\u015f","family":"Erdur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"\u00d6nder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eafak","family":"Pelek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sedef","family":"Alpdo\u011fan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duygu","family":"Demirta\u015f","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7i\u011fdem \u00d6m\u00fcr","family":"Ecevit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zlem","family":"Bekem","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Beh\u00e7et Uz Children\u2019s Hospital, Izmir 35210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"ref_1","first-page":"912","article-title":"Updated S3-guideline for prophylaxis, diagnosis and treatment of gallstones. german society for digestive and metabolic diseases (DGVS) and german society for surgery of the alimentary tract (DGAV)-AWMF registry 021\/008","volume":"56","author":"Gutt","year":"2018","journal-title":"Z. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.3748\/wjg.14.1383","article-title":"Management of cholelithiasis in Italian children: A national multicenter study","volume":"14","author":"Falchetti","year":"2008","journal-title":"World J. Gastroenterol. WJG"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s13312-018-1320-6","article-title":"Etiology and outcome of cholelithiasis in Turkish children","volume":"55","author":"Baran","year":"2018","journal-title":"Indian Pediatr."},{"key":"ref_4","first-page":"172","article-title":"Cholelithiasis and associated complications in pediatric patients","volume":"33","author":"Chamorro","year":"2020","journal-title":"Cir. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.jpedsurg.2016.02.017","article-title":"The increasing incidence of gallbladder disease in children: A 20 year perspective","volume":"51","author":"Murphy","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e82-8","DOI":"10.1542\/peds.2011-0579","article-title":"Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease","volume":"129","author":"Mehta","year":"2012","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/MPG.0b013e3181b99c72","article-title":"Risk factors, complications, and outcomes of gallstones in children: A single-center review","volume":"50","author":"Bogue","year":"2010","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1111\/jpc.13235","article-title":"Risk factors, complications and outcome of cholelithiasis in children: A retrospective, single-centre review","volume":"52","author":"Kirsaclioglu","year":"2016","journal-title":"J. Paediatr. Child Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"228","DOI":"10.4103\/jiaps.JIAPS_107_20","article-title":"Asymptomatic cholelithiasis in children: Management dilemma","volume":"26","author":"Bhaumik","year":"2021","journal-title":"J. Indian Assoc. Pediatr. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/j.jpedsurg.2014.10.051","article-title":"Clinical management of infantile cholelithiasis","volume":"50","author":"Jeanty","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1177\/000992289203101102","article-title":"Cholelithiasis in Infants with Down Syndrome: Three Cases and Literature Review","volume":"31","author":"Aughton","year":"1992","journal-title":"Clin. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1590\/S1516-31802007000600005","article-title":"Cholelithiasis and biliary sludge in Down\u2019s syndrome patients","volume":"125","author":"Llerena","year":"2007","journal-title":"Sao Paulo Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5029","DOI":"10.3748\/wjg.v19.i31.5029","article-title":"Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed","volume":"19","author":"Guarino","year":"2013","journal-title":"World J. Gastroenterol. WJG"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"430","DOI":"10.5223\/pghn.2020.23.5.430","article-title":"Cholecystectomy is feasible in children with small-sized or large numbers of gallstones and in those with persistent symptoms despite medical treatment","volume":"23","author":"Lee","year":"2020","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4292\/wjgpt.v3.i2.7","article-title":"Therapy of gallstone disease: What it was, what it is, what it will be","volume":"3","author":"Portincasa","year":"2012","journal-title":"World J. Gastrointest. Pharmacol. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Diez, S., M\u00fcller, H., Weiss, C., Schellerer, V., and Besend\u00f6rfer, M. (2021). Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-01772-y"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/12\/1553\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:57:23Z","timestamp":1760115443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/12\/1553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,21]]},"references-count":16,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["children11121553"],"URL":"https:\/\/doi.org\/10.3390\/children11121553","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,21]]}}}