Pediatric Urethroscope versus Flexible Choledochoscope for Removal of Distal Protein Plugs and Calculi in Choledochal Cyst: A Prospective Cohort Study

jpedsurg.org

Choledochal cyst (CC) is a common congenital biliary malformation that occurs frequently in children. CC is often complicated by protein plugs, calculi, and other debris, predisposing patients to cholangitis, pancreatitis, and other adverse events. Thorough intraoperative removal of obstructive debris is critical for improving postoperative outcomes. At present, intraoperative endoscopy represents the main modality for removing distal obstructions; however, consensus regarding the comparative efficacy of pediatric urethroscope and flexible choledochoscope remains lacking.

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Article · May 2026 · 1 min read

In brief

Prospective study comparing pediatric urethroscope versus flexible choledochoscope for intraoperative removal of protein plugs and calculi in children with choledochal cyst. Addresses critical need for evidence-based approach to prevent postoperative cholangitis and pancreatitis complications.

Choledochal cysts frequently harbor protein plugs and calculi that increase risk of cholangitis and pancreatitis
Complete intraoperative removal of obstructive debris is essential to optimize postoperative outcomes in CC patients
Intraoperative endoscopy is the primary technique for clearing distal biliary obstructions during CC surgery
Pediatric urethroscope and flexible choledochoscope are both viable options but lack comparative efficacy data

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