WOFAPS 2025 8th World Congress of Pediatric Surgery

Fatma Thamri, Senda Houidi, Yasmine Houas, Bochra Aziza, Yosra Kerkeni, Sondes Sahli, Riadh Jouini, Said Jlidi

Department of Pediatric Surgery, Children’s Hospital, Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

Purpose

Choledochal cyst is a rare congenital anomaly involving cystic dilation of the bile duct. Understanding its presentation and outcomes in a pediatric population is crucial for effective management.

Methods

We performed a retrospective analysis of the medical records of 12 pediatric patients diagnosed with choledochal cyst from 2010 to 2024. The study focused on patient demographics, clinical symptoms, diagnostic results, and outcomes to provide a detailed assessment of the condition.

Results

The patient cohort had a median age of 7.4 years [2.3-13.7] with as ex-ratio of 0.2. Prenatal diagnosis was not identified in any case. Common clinical manifestations included abdominal pain in 87.5% of patients, jaundice in 68.8%, and vomiting in 56.3%. Six patients exhibited signs of biological cholestasis syndrome. Abdominal ultrasonography confirmed the diagnosis of choledochal cyst in all cases. The distribution of choledochal cyst types included 6 cases of Todani type I (50%), 5 cases of type IV (41.6%), and 1 case of type III. All patients underwent surgical intervention, cyst resection with Roux-en-Y hepaticojejunostomy, at a mean age of 7.9 years. Postoperative complications occurred in 13.3% of patients including one case of choleperitoneum due to partial dehiscence of the biliodigestive anastomosis, which necessitated reoperation. The mean duration of postoperative follow-up was 35.1 months (± 30.4), with no recorded deaths.

Conclusion

Understanding choledochal cysts in children is crucial for effective management. Early diagnosis through appropriate imaging and timely surgical intervention are essential to avoid complications and promote favorable long-term results.