Endoscopic biliary drainage for children with persistent or exacerbated symptoms of choledochal cysts

Journal of Hepato-biliary-pancreatic Sciences
Hironori TsuchiyaHisami Ando

Abstract

Symptoms of choledochal cysts sometimes persist or become exacerbated. As preoperative management for patients with these cysts, we prospectively employed endoscopic drainage, based on the theory that protein plugs cause symptoms by obstructing the pancreatobiliary ducts. Children with choledochal cysts underwent endoscopic retrograde cholangiopancreatography (ERCP). When ERCP showed compaction with filling defects in patients with persistent or worsening symptoms (study patients), the placement of a short biliary stent tube was attempted for drainage. The clinical and ERCP findings of the study patients were compared with those of patients who were asymptomatic at ERCP (asymptomatic patients). There were 13 study patients (median age 2.9 years) and 41 asymptomatic patients (4.7 years) enrolled in the study between August 2005 and February 2011. Study patients more frequently had jaundice and elevated transaminase levels. ERCP showed that all study patients had obstruction or compacted filling defects in the common channel or the narrow segment distal to the cyst. Insertion of a stent tube was successful in 11 patients. Symptoms were relieved soon after biliary drainage. Surgery revealed that the obstructing materials were prot...Continue Reading

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Citations

Dec 3, 2014·Journal of the American College of Surgeons·Kevin C SoaresTimothy M Pawlik
Feb 14, 2015·Asian Journal of Endoscopic Surgery·Masaya YamotoMariko Koyama
Apr 26, 2014·Journal of Pediatric Gastroenterology and Nutrition·Takeshi SaitoHideo Yoshida
Nov 23, 2013·Journal of the Korean Surgical Society·Joon-Hyop LeeKwi-Won Park
Apr 16, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Bettina LangeRainer Kubiak
Apr 24, 2021·International Journal of Surgery Case Reports·Sachit AnandPreetha Joshi

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