Intraductal pancreatic calculi in patients with choledochal cyst

Summary Intraductal pancreatic calculi are a rare association in patients with choledochal cyst (CC). Reported herein is a retrospective analysis of the data on pancreatic calculi in 37 patients (10 children and 27 adults) who underwent endoscopic retrograde cholangiopancreatography (ERCP) for CC over a period of 15 years. Five patients (one child and four adults) were identified as having intraductal pancreatic calculi. Three had type I and two had type IV CC. Four underwent cyst excision. No intervention was carried out for the pancreatic calculi. There was no evidence of pancreatic insufficiency on follow up and none had recurrence of abdominal pain. One patient died of cholangitis, which was the initial presenting problem. Intraductal pancreatic calculi associated with CC, although uncommon, are not rare and are not always symptomatic.