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Choledochal Malformation in Children: Lessons Learned from a Dutch National Study
, Maria H A van den Eijnden1, Ruben H J de Kleine2
1Department of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC BA20 Postbus 30.001, 9700RB, Groningen, The Netherlands.
World Journal of Surgery
|June 8, 2017
Summary
Surgery for choledochal malformations (CM) in children has significant short- and long-term complications. Specialized pediatric centers are recommended for these rare hepatobiliary surgeries.
Area of Science:
- Pediatric Surgery
- Hepatobiliary Surgery
- Congenital Malformations
Background:
- Choledochal malformation (CM) is a rare congenital anomaly, particularly in Western populations.
- Understanding the incidence and surgical outcomes of CM in the Netherlands is crucial for improving patient care.
Purpose of the Study:
- To determine the incidence of choledochal malformation (CM) in the Netherlands.
- To evaluate the surgical outcomes and complications associated with CM in pediatric patients.
Main Methods:
- Retrospective analysis of pediatric patients (types I-IV CM) who underwent surgery between 1989 and 2014.
- Exclusion of type V CM cases.
- Data collection on symptoms, surgical details, and short-term (<30 days) and long-term (>30 days) complications.
Main Results:
- 91 pediatric patients underwent surgery for CM at a median age of 2.1 years.
- Short-term complications (biliary leakage, cholangitis) occurred in 22% of patients.
- Long-term complications included cholangitis (13%) and anastomotic stricture (4%); surgery before 1 year and laparoscopic approach were associated with increased long-term complications.
Conclusions:
- Surgery for CM is associated with significant short- and long-term morbidity.
- Hepatobiliary surgery for CM, especially laparoscopic procedures, should be centralized in experienced pediatric surgical centers due to the low incidence and potential for complications.
