WOFAPS 2025 8th World Congress of Pediatric Surgery

Isabel Cristina Canon Reyes, Marco Antonio Bolivar, Maria Alejandra Murcia, Ana Fernanda Garces, Tatiana Daza, Mario Abadia, Fernando Fierro

HOMI Foundation

Purpose The increasing incidence of childhood cholelithiasis and biliary obstructive disease highlights the need for early detection and treatment of choledocholithiasis (CDL). This study aimed to evaluate the diagnostic accuracy of the DUCT score and its risk stratification for Choledocholithiasis in pediatric patients with cholelithiasis at the HOMI Foundation.

Methods A retrospective cohort study was conducted in children (≤18 years) who underwent cholecystectomy for cholelithiasis. The pediatric DUCT score was calculated based on three criteria: (1) common bile duct dilation ≥6 mm, (2) ultrasound evidence of choledocholithiasis, and (3) total bilirubin ≥1.8 mg/dL. Bivariate analysis was performed using the DUCT score as the dependent variable. Chi-square tests were used for categorical variables, and Mann-Whitney U tests for quantitative variables.

Results A total of 178 patients were analyzed. CDL was confirmed in 29 cases (16%) by magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography. The diagnostic accuracy of the DUCT score in our population was 89 % for high-risk and 86% for very high-risk groups, with a specificity of 98% and 99%, respectively.

Conclusion Findings support that the pediatric DUCT criteria effectively predict the presence of CDL and are reproducible in this population.