Related Experiment Videos
[Growth in children with choledochal cyst]
A Sánchez Galán1, A Vilanova Sánchez1, L Martínez Martínez1
1Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
Insights
Choledochal cysts can cause malnutrition in children, but surgical correction quickly resolves this issue. This study shows growth parameters improve significantly after treatment, despite altered digestive anatomy.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Pediatrics
Background:
- Choledochal cysts (CC) represent congenital dilatations of the bile ducts.
- The malformation and subsequent biliodigestive reconstruction create a non-physiological state affecting digestion and biliary excretion.
- This altered physiological state may impact a child's growth and nutritional status.
Purpose of the Study:
- To evaluate the impact of choledochal cysts and their surgical treatment on pediatric growth and nutritional parameters.
- To assess the long-term effects of biliodigestive reconstruction on growth in patients with choledochal cysts.
Main Methods:
- Retrospective review of patients diagnosed with choledochal cysts between 1994 and 2014.
- Collected data included nutritional status, liver function, weight, and height from medical records.
- Excluded patients with other significant diseases affecting growth.
Main Results:
- Thirty-seven patients with choledochal cysts (75% female) underwent cyst resection and Roux-en-Y hepaticojejunostomy.
- At diagnosis, 10.8% of patients presented with low weight.
- Low weight was fully resolved within 6 months post-surgery (p<0.05).
Conclusions:
- Choledochal cysts are associated with moderate malnutrition in approximately 10% of pediatric patients.
- Surgical correction effectively and rapidly reverses malnutrition.
- Growth parameters improve post-surgery despite altered anatomy and biliary diversion.
Aim:
In patients with a choledochal cyst, the malformation and subsequent biliodigestive reconstruction lead to a non-physiological state in the digestive tract and biliary excretion that could affect the child's growth. The effect of this malformation and its surgical treatment are reviewed here in a large patient cohort.
Material And Methods:
Retrospective review of patients undergoing surgery for choledochal cyst in the last 20 years. Nutrition and liver function parameters, weight and height data were collected from medical records. Patients presenting other serious diseases affecting growth were excluded.
Results:
From 1994-2014 forty-five patients were diagnosed for choledochal cyst (75% female). All underwent cyst resection followed by Roux-en-Y hepaticojejunostomy. Eight patients were excluded for comorbidities and 37 selected for the study, with a median age at diagnosis and surgery of 16 (0-120) and 24 (1-149) months, respectively. The median follow-up was 76 (1-215) months. At diagnosis, 10.8% of patients had low weight, which was entirely resolved within 6 months after surgery (p< 0.05).
Conclusions:
The choledochal cyst induces a situation of moderate malnutrition in around 10% of the patients. Surgical correction quickly reverses this situation, despite the decreased absorption surface and deviation of biliary secretion to the jejunum instead of the duodenum.