Related Experiment Video
Updated: May 14, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Endoscopic management of biliary complications after partial liver resection in children
Mette W Steen1, Roel Bakx, Merit M Tabbers
1Paediatric Surgical Centre of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) aids in diagnosing and treating bile leaks after pediatric liver resection. While effective for leaks, its role in managing biliary strictures requires further investigation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Biliary complications post-liver resection are challenging in children.
- Endoscopic retrograde cholangiopancreatography (ERCP) with stenting is infrequently used in pediatric patients for these complications.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic utility of ERCP in managing biliary complications following liver resection in pediatric patients.
Main Methods:
- Retrospective review of pediatric patients (0-18 years) who underwent partial liver resection between 2000-2010.
- Analysis of ERCP procedures for diagnosis and treatment of post-operative biliary complications.
Main Results:
- Of 45 children undergoing liver resection, 13 had biliary complications.
- ERCP successfully treated bile leaks in 5 of 8 patients and resolved strictures in 1 of 2 patients.
- ERCP accurately identified the nature, extent, and location of biliary lesions in 80% of cases with no serious procedure-related complications.
Conclusions:
- ERCP with stenting is a valuable tool for diagnosing and managing bile leaks after pediatric liver resection.
- The efficacy of ERCP for biliary strictures in children remains less conclusive and warrants further study.
Background:
Biliary complications after liver surgery are difficult to manage. Endoscopic retrograde cholangiopancreatography (ERCP) with stenting of the common bile duct is not commonly practiced in children for this purpose. The aim of this retrospective review is to evaluate the role of ERCP as both a diagnostic and a therapeutic tool in the management of biliary complications after liver resection in children.
Patients And Methods:
The charts of all patients from 0 to 18 years old who underwent partial liver resection in a tertiary children's hospital in Amsterdam, the Netherlands, between 2000 and 2010 were retrospectively reviewed.
Results:
Forty-five children (median age: 3.6 years, range: 2 months-17 years) underwent partial liver resection. Post-operative biliary complications occurred in 13 children. Ten patients were suffering from bile leakage. Eight of them underwent ERCP with stent placement after which leakage stopped in 5 patients. Three patients presented with a post-operative biliary tract stricture. ERCP with dilation and stent placement was performed in 2 of them, which solved the problem in one patient. ERCP demonstrated the nature (bile leak and/or biliary tract stricture(s)), extent, and location of the lesion in 8 of 10 children. There were no serious procedure related complications. Rescue procedures in the other patients included hepaticojejunostomy and liver transplant.
Conclusion:
ERCP with stenting of the common bile duct has a diagnostic and therapeutic role in the management of bile leaks after partial liver resection in children. The value of ERCP in the management of a stricture of the biliary tract is less conclusive.
