[Endoscopic papillosphincterotomy in early childhood]

Area of Science:

• Pediatric Gastroenterology
• Hepatobiliary Surgery
• Endoscopic Procedures

Background:

• Cholelithiasis can lead to choledocholithiasis, which is uncommon in pediatric patients.
• Management of distal common bile duct obstruction in children depends on therapeutic efficacy and co-existing anomalies.
• Choledocholithiasis presents unique challenges in pediatric cases, particularly regarding surgical intervention.

Purpose of the Study:

• To report a rare case of pediatric choledocholithiasis.
• To highlight the successful endoscopic management of choledocholithiasis in a young child.
• To discuss the technical difficulties and outcomes associated with endoscopic retrograde cholangiopancreatography (ERCP) in low-body-weight pediatric patients.

Main Methods:

• A clinical case study of a 2-year-old girl with symptomatic choledocholithiasis.
• Diagnostic workup included clinical assessment, laboratory tests, and instrumental examinations.
• Therapeutic intervention involved endoscopic retrograde typical papillosphincterotomy.

Main Results:

• The patient presented with abdominal pain, gray stools, and jaundice, indicative of choledocholithiasis.
• Endoscopic retrograde typical papillosphincterotomy was successfully performed without complications.
• The child demonstrated positive clinical and laboratory improvements post-procedure and was discharged on postoperative day 3.

Conclusions:

• Endoscopic retrograde cholangiopancreatography is a viable and effective treatment for pediatric choledocholithiasis.
• Low body weight in pediatric patients can present technical challenges during ERCP.
• Sufficient expertise in pediatric endoscopic procedures is crucial for achieving favorable outcomes in complex cases.