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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1523753

The effectiveness of ERCP in managing preoperative complications of choledochal cysts in children and its role in facilitating early surgical intervention

Provisionally accepted
Tian Zhang Tian Zhang Wenjie Wu Wenjie Wu *Yijun Shu Yijun Shu *Hao Weng Hao Weng *Mingzhe Weng Mingzhe Weng *Ying Zhou Ying Zhou *Xuefeng Wang Xuefeng Wang *
  • Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Currently, there is no established guideline for the application of ERCP in children with choledochal cyst. This study aimed to investigate the safety and effectiveness of ERCP in managing preoperative complications of choledochal cyst in children, as well as the timing for definitive surgery following ERCP.We conducted a retrospective review of medical records for 68 pediatric patients who presented with complications of choledochal cyst, including pancreatitis and biliary obstruction combined with cholangitis. All patients underwent ERCP treatment followed by definitive surgery. The primary outcomes assessed included treatment efficacy, post-ERCP complication, and the impact of ERCP on definitive surgical procedures.Among the 68 patients studied, 41 presented with pancreatitis, while the remaining patients had biliary obstruction and cholangitis. Sixty-five patients successfully completed their treatments, with 64 experiencing alleviation of symptoms. Significant improvements were observed in serum amylase levels and liver function tests following ERCP. Post-ERCP complications occurred in three cases, including one case of pancreatitis and two cases of infection. The median interval between ERCP and surgery was 11 days. There was no significant difference in primary outcomes, such as surgical duration, rate of minimally invasive surgery, conversion to open surgery, intraoperative bleeding volume, intraoperative blood transfusion, postoperative complications, or average length of hospital stay, between the early surgery group (≤2 weeks) and the late surgery group (>2 weeks).ERCP was proved to be a safe and effective intervention for alleviating preoperative complications in pediatric patients with choledochal cyst. Early definitive surgery following ERCP did not significantly impact the perioperative outcomes of pediatric patients.

    Keywords: Children, ERCP, Choledochal Cyst, complication, Surgery

    Received: 06 Nov 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Zhang, Wu, Shu, Weng, Weng, Zhou and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Wenjie Wu, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Yijun Shu, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Hao Weng, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Mingzhe Weng, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Ying Zhou, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Xuefeng Wang, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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