Role of endoscopic retrograde cholangiopancreatography in diagnosis and management of congenital choledochal cysts: 28 pediatric cases

Paola De Angelis, Francesca Foschia, Erminia Romeo, Tamara Caldaro, Francesca Rea, Giovanni Federici Di Abriola, Romina Caccamo, Maria Rita Santi, Filippo Torroni, Lidia Monti, Luigi Dall'Oglio

Research output: Contribution to journalArticle

Abstract

Background/purpose: Management of choledochal cysts consists of surgical excision and hepaticojejunal anastomosis. Endoscopic retrograde cholangiopancreatography (ERCP) can be used to resolve complications and to evaluate the biliary tract and pancreatobiliary duct junction. Our aim was to underline the importance of ERCP for optimal management. Methods: From 2005 to 2011, 28 patients were reviewed (21 female, 7 male; mean age, 5.71 years; range, 2-16 years). After imaging, all patients underwent elective ERCP and were referred for surgery. Results: Choledochal cyst was diagnosed at ultrasound and magnetic resonance cholangiopancreatography in all examined patients; common biliopancreatic duct was diagnosed in 3 (20%) of 15 patients at magnetic resonance cholangiopancreatography and in none at ultrasound. Endoscopic retrograde cholangiopancreatography showed choledochal cyst in all patients and common biliopancreatic duct in 19 (68%) of 28 patients. Twelve patients underwent sphincterotomy. All patients underwent surgical extrahepatic biliary tree resection and hepaticojejunal anastomosis. Mean period of hospitalization was 9.5 days (range, 6-13 days). No major complications related to ERCP were observed. Two patients needed postoperative ERCP for complications (pancreatitis during follow-up). Conclusions: In our pediatric experience, ERCP is feasible and safe. It can rule out other possible biliary tract anomalies and help plan the timing and choice of the appropriate surgical procedure.

Original languageEnglish
Pages (from-to)885-888
Number of pages4
JournalJournal of Pediatric Surgery
Volume47
Issue number5
DOIs
Publication statusPublished - May 2012

Keywords

  • Choledochal cyst
  • ERCP, children

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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