Pancreatic complications in pediatric choledochal cysts.
OBJECTIVE
The aim of this study is to clarify the clinical features and risk factors of pre- and postoperative pancreatic complications in pediatric choledochal cysts.


METHODS
A retrospective chart review was carried out on pediatric patients with choledochal cysts who underwent radical operation at our department.


RESULTS
Twenty-one, 24, and 24 patients were classified into the Todani Ia, Ic, and IV-A choledochal cyst, respectively. Preoperative acute pancreatitis and protein plugs were observed in 31 (43.7%) and 11 (15.5%) patients, respectively. Patients with preoperative pancreatitis were more likely to have fusiform dilatation of choledochal cysts (79.3% vs. 35.0%) and a dilated common channel (53.9% vs. 23.1%) compared to those without preoperative pancreatitis. Compared to patients without preoperative protein plugs, those with protein plugs were more likely to have fusiform dilatation (90.9% vs. 46.5%) and pancreatic divisum with communicating ducts and a dilated ductal system (60.0% vs. 2.5%). Postoperatively, three patients (4.2%) experienced acute pancreatitis. One of these and all 3 had protein plugs and preoperative pancreatitis, respectively.


CONCLUSIONS
Fusiform-type choledochal cyst is a significant risk factor for preoperative pancreatic complications in choledochal cysts. While postoperative pancreatic complications were relatively rare, preoperative pancreatic complications might be risk factors for postoperative pancreatitis.
Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Japan. Electronic address: jfujishi-tky@umin.ac.jp.
Jun
J
Fujishiro
Kouji
K
Masumoto
Yasuhisa
Y
Urita
Toko
T
Shinkai
Chikashi
C
Gotoh
D000681:Amylases / Q000097:blood; D000713:Anastomosis, Roux-en-Y; D001663:Bilirubin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000145:classification / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002779:Cholestasis / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D004108:Dilatation, Pathologic / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007582:Jejunostomy; D008099:Liver / Q000601:surgery; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D000637:Transaminases / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000637:Transaminases; D000681:Amylases; D001663:Bilirubin
Acute pancreatitis; Choledochal cyst; Protein plug