{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:56:56Z","timestamp":1775127416066,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>Background: Symptomatic cholelithiasis is the leading indication for pediatric cholecystectomy. While historically linked to hemolytic disorders, non-hemolytic gallbladder disease in children has become increasingly common in recent decades. Objective: The objective of this study was to describe the distribution and temporal trends of indications for cholecystectomy among children (ages \u2264 19 years) undergoing surgery at a tertiary pediatric center in Israel and to compare clinical presentation between hemolysis-related and non-hemolysis-related cases. Methods: We conducted a retrospective observational cohort study of all pediatric patients who underwent cholecystectomy at Schneider Children\u2019s Medical Center between 2011 and 2024. Patients with congenital biliary tract anomalies or biliary tract neoplasms were excluded. Results: A total of 199 cholecystectomies were performed (median age 13.4 years). Hemolysis-related cholelithiasis accounted for 34.2% of cases; five patients (2.5%) had gallbladder polyps or other benign lesions, while the remaining patients had non-hemolysis-related cholelithiasis. No cases of biliary dyskinesia were identified. The proportion of non-hemolysis-related cholecystectomies remained stable over time. Among symptomatic patients, the rate of choledocholithiasis was significantly higher in the hemolysis-related group compared to the non-hemolysis group (27% vs. 7.9%, p = 0.004). No statistically significant association was observed between obesity and increased disease severity or adverse outcomes. Conclusion: Unlike trends reported in some Western countries, the number of cholecystectomies performed for non-hemolysis-related cholelithiasis in our single-center cohort did not increase over time. Hemolysis-related disease remains a leading indication for pediatric cholecystectomy. Prophylactic surgery may help prevent biliary complications in this group while symptomatic patients have substantial complication rates.<\/jats:p>","DOI":"10.3390\/epidemiologia7020047","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:26:12Z","timestamp":1775121972000},"page":"47","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cholecystectomy in the Pediatric Population\u2014What Has Changed in Recent Decades? Insight from a Tertiary Pediatric Referral Center"],"prefix":"10.3390","volume":"7","author":[{"given":"Tal","family":"Weiss","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"},{"name":"School of Medicine, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"},{"name":"Department of General Surgery, Hillel Yaffe Medical Center, The Rapaport School of Medicine, Technion, Haifa 3525433, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Dreznik","sequence":"additional","affiliation":[{"name":"School of Medicine, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"},{"name":"Department of Pediatric and Adolescent Surgery, Schneider Children\u2019s Medical Center of Israel, Petah-Tiqwa 4920235, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Kravarusic","sequence":"additional","affiliation":[{"name":"School of Medicine, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"},{"name":"Department of Pediatric and Adolescent Surgery, Schneider Children\u2019s Medical Center of Israel, Petah-Tiqwa 4920235, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3300-1769","authenticated-orcid":false,"given":"Samah","family":"Hayek","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"},{"name":"Clalit Innovation, Clalit Health Services, Ramat-Gan 5252247, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1097\/00000658-198005000-00015","article-title":"Cholecystitis, cholelithiasis and common duct stenosis in children and adolescents","volume":"191","author":"Holcomb","year":"1980","journal-title":"Ann. 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