Related Experiment Video
Updated: Jun 6, 2025
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Endoscopic cystostomy and biliary sphincterotomy for choledochoceles: A pediatric case series
Michelle Saad1,2, Maisam Abu-El-Haija1,2, Tom K Lin1,2
1Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA.
Insights
Endoscopic management of choledochoceles (type III choledochal cysts) in children offers a successful treatment option. This minimally invasive approach led to sustained symptom resolution and radiographic improvement in pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endoscopic Procedures
Background:
- Choledochoceles, a type of choledochal cyst, present varied management challenges in pediatric patients.
- Symptoms often include abdominal pain and pancreatitis, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of endoscopic management for pediatric choledochoceles.
- To assess the long-term outcomes of cystostomy and biliary sphincterotomy in children with choledochoceles.
Main Methods:
- Retrospective review of three pediatric patients (ages 12-13) with symptomatic choledochoceles.
- Endoscopic cystostomy and biliary sphincterotomy performed for choledochal cyst treatment.
- Pre- and post-procedure imaging (MRI) and tumor marker assessment.
Main Results:
- Successful endoscopic treatment of choledochoceles in all three pediatric patients.
- Sustained clinical improvement and radiographic resolution at 2-year follow-up.
- Normal tumor markers post-procedure, indicating no malignancy.
Conclusions:
- Endoscopic management with cystostomy and biliary sphincterotomy is a viable therapeutic option for pediatric choledochoceles.
- This approach can achieve sustained symptom resolution and radiographic healing.
- Malignancy risk in choledochoceles is rare, supporting less invasive treatment modalities.
Abstract:
Management of choledochoceles (type III choledochal cysts) in children varies. We highlight the potential role of endoscopic management of choledochoceles with cystostomy and biliary sphincterotomy through a series of three successfully treated pediatric patients aged 12-13 at our tertiary center. Patients presented with symptoms including abdominal pain and pancreatitis. Choledochoceles were identified by preprocedure imaging on magnetic resonance imaging, with sizes ranging between 7 and 15 mm in maximal diameter. Histology revealed two choledochoceles lined by biliary epithelium and one by intestinal epithelium. Clinical improvement was sustained at a 2-year follow-up, with radiographic resolution on repeat imaging and normal tumor markers. We conclude that endoscopic management of choledochoceles with cystostomy and biliary sphincterotomy is a therapeutic option in children and can lead to sustained resolution of associated symptoms. While there is some lifetime risk of malignancy with choledochal cysts, malignancy in choledochoceles is rare.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease