Liu Denghui,Xiao Xiaoyi,Liu Yuanzhuo,et al.Diagnosis and treatment of choledochal cysts complicated with complications in children[J].Journal of Clinical Pediatric Surgery,,():220-226.[doi:10.3760/cma.j.cn101785-20251120-00071]
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Diagnosis and treatment of choledochal cysts complicated with complications in children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2026 03 Page: 220-226 Column: 专题·胆总管囊肿 Date of publication: 2026-03-28
Author(s):
Liu Denghui1;  Xiao Xiaoyi1;  Liu Yuanzhuo1;  Tang Xianglian1;  Li Ming1;  Ouyang Hongjuan2;  Li Yong1; 3
1. Department of General Surgery, Affiliated Children’s Hospital, Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha 410007, China;
2. Department of Digestive and Nutritional Sciences, Affiliated Children’s Hospital, Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha 410007, China;
3. Department of General Surgery, Municipal People’s Hospital, Turpan 838000, China
Keywords:
Child; Choledochal Cysts; Complication; Diagnosis; Treatment
DOI:
10.3760/cma.j.cn101785-20251120-00071
Abstract:
Objective To summarize the clinical characteristics,diagnostic and therapeutic experience of choledochal cysts (CDCs) with complications in children.Methods For this retrospective case series study,the relevant clinical data were reviewed for 176 children withfrom January 2015 to December 2024.There were 40 boys and 136 girls with an age range of 2 months and 15 days to 9 years and a median age of 4 years and8months.The complications included biliary perforation (BP,n=37),biliary pancreatitis (n=53) and cholangitis with obstructive jaundice and liver dysfunction (n=86).The major clinical manifestations were abdominal pain,fever,vomiting and scleral icterus.Most of them had two or more clinical manifestations or complications.Results Among 37 BP children,31 cases with biliary peritonitis underwent one-stage external biliary drainage.It was followed by two-stage radical resection of choledochal cyst (cholecystectomy+choledochal cyst resection+Roux-en-Y hepaticojejunostomy) at Month (2-3).Six cases of occult BP underwent one-stage radical resection of choledochal cyst directly.For 53 children with biliary pancreatitis,preoperative measures included anti-infection,enzyme reduction,acid suppression and endoscopic nasobiliary drainage.One-stage radical resection of choledochal cyst was performed after amylase returned to near normal.For 86 children with cholangitis with obstructive jaundice and liver dysfunction,preoperative interventions were anti-inflammation,cholagogues,jaundice reduction and nasobiliary drainage via Endoscopic retrograde cholangiopancreatography (ERCP) were performed.After jaundice subsided and transaminase returned to near normal,one-stage radical resection of choledochal cyst (n=58) and one-stage external biliary drainage + staged radical surgery (n=5).In 5 children,external drainage was followed by two-stage radical surgery due to failed endoscopic retrograde cholangiopancreatography (ERCP).Among those with external biliary drainage,there were electrolyte disturbances (n=7) and T-tube dislodgment in later period (n=4).Radical surgery was performed at Month 2-3 after active interventions.The postoperative follow-up period was 15 to 41 months with a median follow-up time of 22 months.Nine children had a history of recurrent cholangitis after surgery and 4 had a history of chronic pancreatitis after surgery.All of them were relieved by conservative measures.And 4/12 children were operated due to postoperative intestinal obstruction.Conclusions Early identification and precise diagnosis are necessary for children with CDCs complicated with preoperative complications.Selecting appropriate treatments and surgical approaches based upon specific conditions and general profiles of children may effectively lower the occurrence of postoperative complications.

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收稿日期:2025-11-20。
基金项目:湖南省省级科技计划资助(2020SK50501,2023JJ30323)
通讯作者:李勇,Email:liyongpuwaike@163.com

Last Update: 1900-01-01