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An observational study on the prevalence of choledochal cyst with pancreatitis: Geographical implications and

Shalini G Hegde1, Prassanna Venkatesh1, Elaine A Mathew2

  • 1Department of Paediatric Surgery, St. John's Medical College Hospital, Bangalore, Karnataka, India.

Journal of Pediatric Gastroenterology and Nutrition
|January 31, 2024
PubMed

Insights

This study found that 40.2% of Indian children with choledochal cysts (CDC) also had pancreatitis, with a significant portion showing chronic pancreatitis. This complication may be unique to the Indian subcontinent.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Hepatology

Background:

  • Choledochal cyst (CDC) is a rare congenital anomaly of the biliary tract.
  • Pancreatitis is a known complication of CDC, but chronic pancreatitis in this context is poorly understood, especially in pediatric populations.
  • The Indian subcontinent may have unique epidemiological patterns for CDC and its complications.

Purpose of the Study:

  • To analyze the prevalence and risk factors of pancreatitis in Indian children with CDC.
  • To investigate the need for intervention in these patients.
  • To specifically focus on the occurrence and characteristics of chronic pancreatitis in pediatric CDC.

Main Methods:

  • Retrospective review of medical records of children with CDC over an 11-year period.
  • Identification of pancreatitis using INSPPIRE guidelines (enzyme elevation or radiological imaging).
  • Comparison of risk factors between children with CDC alone and those with CDC and pancreatitis.

Main Results:

  • 40.2% of children with CDC presented with pancreatitis.
  • Children with pancreatitis had significantly higher age, total bilirubin, indirect bilirubin, and required more interventions.
  • Among those with radiological pancreatitis, 47% exhibited imaging features of chronic pancreatitis.

Conclusions:

  • Pancreatitis is a common complication of choledochal cysts in Indian children.
  • Chronic pancreatitis, previously unreported in pediatric CDC, appears to be prevalent in this cohort.
  • These findings suggest that chronic pancreatitis in CDC may be a distinct entity peculiar to the Indian subcontinent.

Keywords:
ERCPchildrenchronic pancreatitisrisk factors

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