Endoscopic cystostomy and biliary sphincterotomy for choledochoceles: A pediatric case series

Abstract

Management of choledochoceles (type III choledochal cysts) in children varies. We highlight the potential role of endoscopic management of choledochoceles with cystostomy and biliary sphincterotomy through a series of three successfully treated pediatric patients aged 12–13 at our tertiary center. Patients presented with symptoms including abdominal pain and pancreatitis. Choledochoceles were identified by preprocedure imaging on magnetic resonance imaging, with sizes ranging between 7 and 15 mm in maximal diameter. Histology revealed two choledochoceles lined by biliary epithelium and one by intestinal epithelium. Clinical improvement was sustained at a 2‐year follow‐up, with radiographic resolution on repeat imaging and normal tumor markers. We conclude that endoscopic management of choledochoceles with cystostomy and biliary sphincterotomy is a therapeutic option in children and can lead to sustained resolution of associated symptoms. While there is some lifetime risk of malignancy with choledochal cysts, malignancy in choledochoceles is rare.