title: Role of endoscopic retrograde cholangiopancreatography in diagnosis and management of congenital choledochal cysts: 28 pediatric cases.
abstract: OBJECTIVE
  Management of choledochal cysts consists of surgical excision and hepaticojejunal anastomosis. Endoscopic retrograde cholangiopancreatography (ERCP) can be used to resolve complications and to evaluate the biliary tract and pancreatobiliary duct junction. Our aim was to underline the importance of ERCP for optimal management.
  
  
  METHODS
  From 2005 to 2011, 28 patients were reviewed (21 female, 7 male; mean age, 5.71 years; range, 2-16 years). After imaging, all patients underwent elective ERCP and were referred for surgery.
  
  
  RESULTS
  Choledochal cyst was diagnosed at ultrasound and magnetic resonance cholangiopancreatography in all examined patients; common biliopancreatic duct was diagnosed in 3 (20%) of 15 patients at magnetic resonance cholangiopancreatography and in none at ultrasound. Endoscopic retrograde cholangiopancreatography showed choledochal cyst in all patients and common biliopancreatic duct in 19 (68%) of 28 patients. Twelve patients underwent sphincterotomy. All patients underwent surgical extrahepatic biliary tree resection and hepaticojejunal anastomosis. Mean period of hospitalization was 9.5 days (range, 6-13 days). No major complications related to ERCP were observed. Two patients needed postoperative ERCP for complications (pancreatitis during follow-up).
  
  
  CONCLUSIONS
  In our pediatric experience, ERCP is feasible and safe. It can rule out other possible biliary tract anomalies and help plan the timing and choice of the appropriate surgical procedure.
authors.affiliation: Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. paola.deangelis@opbg.net
authors.forename: Paola
authors.initials: P
authors.lastname: De Angelis
authors.forename: Francesca
authors.initials: F
authors.lastname: Foschia
authors.forename: Erminia
authors.initials: E
authors.lastname: Romeo
authors.forename: Tamara
authors.initials: T
authors.lastname: Caldaro
authors.forename: Francesca
authors.initials: F
authors.lastname: Rea
authors.forename: Giovanni Federici
authors.initials: GF
authors.lastname: di Abriola
authors.forename: Romina
authors.initials: R
authors.lastname: Caccamo
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Santi
authors.forename: Filippo
authors.initials: F
authors.lastname: Torroni
authors.forename: Lidia
authors.initials: L
authors.lastname: Monti
authors.forename: Luigi
authors.initials: L
authors.lastname: Dall'Oglio
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome