title: Acute pancreatitis complicating choledochal cysts in children.
abstract: OBJECTIVE
  To analyse the characteristics of patients with choledochal cysts presenting with acute pancreatitis.
  
  
  METHODS
  Multicenter retrospective review of all paediatric patients (<18 years) with choledochal cysts managed over a 14-year period (2001-2014) at two tertiary paediatric surgical centres. Patient data were analysed for demographics, presentation, radiological classification of cyst type (Todani), operative interventions, complications and long-term follow-up.
  
  
  RESULTS
  A total of 49 patients with choledochal cysts were identified with 15 (31%) being Type I fusiform, 18 (37%) Type I cystic and 16 (32%) Type IV-A. Seventeen (35%) patients presented with acute pancreatitis, one having had an ante-natally diagnosed choledochal cyst. Patients presenting with pancreatitis were older when compared to the non-pancreatitis group (5.1 vs. 1.2 years, P = 0.005). Nine out of 16 (53%) patients with Type IV-A cysts presented with pancreatitis compared to five (33%) of Type I fusiform and three (17%) of Type I cystic. There was however no statistically significant association between Todani types and the development of pancreatitis (Type I fusiform, P = 1.0; Type I cystic, P = 0.063; Type IV-A, P = 0.053). The rate of complications was similar in both groups.
  
  
  CONCLUSIONS
  Pancreatitis was a common presentation in children with a choledochal cyst, however, there was no clear statistically significant association with Todani types and pancreatitis.
authors.affiliation: Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Mathievathaniy
authors.initials: M
authors.lastname: Muthucumaru
authors.affiliation: Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Damir
authors.initials: D
authors.lastname: Ljuhar
authors.affiliation: Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Gayathri
authors.initials: G
authors.lastname: Panabokke
authors.affiliation: Monash Centre for Health Research and Implementation, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Eldho
authors.initials: E
authors.lastname: Paul
authors.affiliation: Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Nataraja
authors.affiliation: Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Ferguson
authors.affiliation: Department of Medical Imaging, The Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Charuta
authors.initials: C
authors.lastname: Dagia
authors.affiliation: Department of Paediatric Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.|Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Clarnette
authors.affiliation: Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.|Surgical Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Sebastian
authors.initials: S
authors.lastname: King
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: cholangitis; choledochal cyst; cholestasis; pancreatico-biliary duct junction; pancreatitis