Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center

BackgroundCongenital biliary dilatation (CBD) is a congenital malformation of the main biliary tract usually associated with the pancreatobiliary maljunction (PBM), determining stone formation, cholangitis, pancreatitis, and cholangiocarcinoma. The role of endoscopic retrograde cholangiopancreatogra...

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Main Authors: Giovanni Rollo, Valerio Balassone, Simona Faraci, Filippo Torroni, Luigi Dall'Oglio, Paola De Angelis, Tamara Caldaro
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2024.1484375/full
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author Giovanni Rollo
Valerio Balassone
Simona Faraci
Filippo Torroni
Luigi Dall'Oglio
Paola De Angelis
Tamara Caldaro
author_facet Giovanni Rollo
Valerio Balassone
Simona Faraci
Filippo Torroni
Luigi Dall'Oglio
Paola De Angelis
Tamara Caldaro
author_sort Giovanni Rollo
collection DOAJ
description BackgroundCongenital biliary dilatation (CBD) is a congenital malformation of the main biliary tract usually associated with the pancreatobiliary maljunction (PBM), determining stone formation, cholangitis, pancreatitis, and cholangiocarcinoma. The role of endoscopic retrograde cholangiopancreatography (ERCP) in treatment and diagnosis has not been established yet. Therefore, the aim of our study is to define the actual role of ERCP in children with CBD.MethodsA retrospective review of consecutive patients with congenital biliary dilatation undergoing preoperative ERCP and subsequent surgical treatment at our pediatric tertiary referral center (Endoscopy and Digestive Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy) was performed between 2012 and 2023.ResultsA total of 31 patients were included in the present study. Preoperative ERCP detected a PBM in 28 patients (90%). According to Todani's classification, 2 patients (6.5%) had choledochal cyst (CC) type IV, and 29 patients (93.5%) were diagnosed with CC type I. In 18 (58%) patients, ERCP was performed for treating acute pancreatitis. Sphincterotomy could be performed in 23 of 31 (74%) patients. Patients who did not undergo sphincterotomy had a higher number of acute episodes while awaiting surgery.ConclusionsThe present study is supportive of an essential role of ERCP in the diagnostic and preoperative management of children with CBD with acute presentation or inconclusive magnetic resonance cholangiopancreatography findings.
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spelling doaj-art-71ab48ab16a04469ac2670eb808ba9b52025-01-06T06:58:52ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14843751484375Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary centerGiovanni Rollo0Valerio Balassone1Simona Faraci2Filippo Torroni3Luigi Dall'Oglio4Paola De Angelis5Tamara Caldaro6Digestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyGastroenterology and Nutrition Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyGastroenterology and Nutrition Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyGastroenterology and Nutrition Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyBackgroundCongenital biliary dilatation (CBD) is a congenital malformation of the main biliary tract usually associated with the pancreatobiliary maljunction (PBM), determining stone formation, cholangitis, pancreatitis, and cholangiocarcinoma. The role of endoscopic retrograde cholangiopancreatography (ERCP) in treatment and diagnosis has not been established yet. Therefore, the aim of our study is to define the actual role of ERCP in children with CBD.MethodsA retrospective review of consecutive patients with congenital biliary dilatation undergoing preoperative ERCP and subsequent surgical treatment at our pediatric tertiary referral center (Endoscopy and Digestive Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy) was performed between 2012 and 2023.ResultsA total of 31 patients were included in the present study. Preoperative ERCP detected a PBM in 28 patients (90%). According to Todani's classification, 2 patients (6.5%) had choledochal cyst (CC) type IV, and 29 patients (93.5%) were diagnosed with CC type I. In 18 (58%) patients, ERCP was performed for treating acute pancreatitis. Sphincterotomy could be performed in 23 of 31 (74%) patients. Patients who did not undergo sphincterotomy had a higher number of acute episodes while awaiting surgery.ConclusionsThe present study is supportive of an essential role of ERCP in the diagnostic and preoperative management of children with CBD with acute presentation or inconclusive magnetic resonance cholangiopancreatography findings.https://www.frontiersin.org/articles/10.3389/fped.2024.1484375/fullcongenital biliary dilatationspancreatitisendoscopic retrograde cholangiopancreatographypancreatobiliary maljunctionpediatrics
spellingShingle Giovanni Rollo
Valerio Balassone
Simona Faraci
Filippo Torroni
Luigi Dall'Oglio
Paola De Angelis
Tamara Caldaro
Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
Frontiers in Pediatrics
congenital biliary dilatations
pancreatitis
endoscopic retrograde cholangiopancreatography
pancreatobiliary maljunction
pediatrics
title Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
title_full Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
title_fullStr Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
title_full_unstemmed Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
title_short Endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction: experience from a tertiary center
title_sort endoscopic retrograde cholangiopancreatography in children with pediatric congenital biliary dilatation associated with pancreatobiliary maljunction experience from a tertiary center
topic congenital biliary dilatations
pancreatitis
endoscopic retrograde cholangiopancreatography
pancreatobiliary maljunction
pediatrics
url https://www.frontiersin.org/articles/10.3389/fped.2024.1484375/full
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