Long-term follow-up after choledochal cyst excision in children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Outcomes Research

Background:

• Choledochal cyst (CC) excision is crucial to prevent complications.
• Current guidelines lack consensus on postoperative follow-up protocols for CC excision.
• This study evaluates long-term outcomes and adherence to a 5-year follow-up protocol at our institution.

Purpose of the Study:

• To assess long-term post-operative outcomes following pediatric choledochal cyst excision.
• To evaluate adherence to a 5-year institutional follow-up protocol.
• To identify late complications after CC excision.

Main Methods:

• Retrospective chart review of pediatric patients undergoing CC excision (1986-2025).
• Defined late complications as those occurring over 5 years post-surgery.
• Compared outcomes between early (1986-2001) and modern (2002-2025) management eras.

Main Results:

• 49 of 57 patients (86%) had outcomes analyzed; median follow-up was 2.4 years.
• Only 22 of 50 patients (44%) met the 5-year follow-up criteria.
• 36% (8/22) of those with ≥5 years follow-up experienced late complications; 8 patients transitioned to adult care.

Conclusions:

• Pediatric choledochal cyst excision offers good long-term outcomes, but significant late complications are possible.
• Current 5-year follow-up protocols may not capture all late complications.
• Further studies are required to define optimal long-term surveillance, especially during transition to adult care.