ArticlePediatric surgery international2025
A comparative study of childhood versus adult-onset biliary complications following pediatric choledochal cyst surgery.
Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Age-Dependent Dynamics of the Biliary Microbiome in Children with Choledochal Cysts: Functional Remodeling Underlying Taxonomic Conservation.Pathogens (Basel, Switzerland) · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the clinical characteristics and management of biliary complications in pediatric and adult patients who underwent choledochal cysts (CDCs) surgery in childhood.
methodsA retrospective cohort study was conducted at Beijing Tsinghua Changgung Hospital, including 34 patients who developed biliary complications after undergoing CDC surgery during childhood. Patients were stratified into two groups: Group A (childhood-onset, < 18 years, n = 14) and Group B (adult-onset, ≥ 18 years, n = 20). Clinical presentation, imaging, laboratory findings, surgical history and treatment were analyzed.
resultsThe median interval from initial CDC surgery to complication onset was significantly shorter in Group A than in Group B (1.5 vs. 15.0 years; p < 0.001). The primary presentation of biliary complications in both groups were cholangitis, with no significant differences in liver function or bilirubin levels. Biliary strictures were the predominant cause in children (85.7% vs. 36.8%; p = 0.011), whereas adult patients more commonly exhibited non-obstructive intrahepatic bile duct dilation (63.2% vs. 14.3%; p = 0.011) and intrahepatic stones (73.7% vs. 28.6%; p = 0.015). Hilar ductoplasty with hepaticojejunostomy revision was the primary surgical strategy in children (85.7% vs. 11.8%; p < 0.001), while adults often required partial hepatectomy combined with biliary reconstruction (82.4% vs. 0%; p < 0.001).Two adults developed biliary malignancies > 30 years postoperatively-adenocarcinoma after cystoduodenostomy and cholangiocarcinoma after hepaticojejunostomy.
conclusionsBiliary complications following childhood CDC surgery may arise either early in life or decades later, with differing etiologies and surgical approaches depending on age at presentation. Timely recognition and individualized surgical management are essential, and lifelong follow-up is warranted due to the risk of late complications, including malignancy.
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