Endoscopic Retrograde Cholangiopancreatography (ERCP) Findings in Pediatric Patients with Choledocholithiasis Justify a Surgery-First Approach: A Multi-Center Study
Author / Expert
Alison Lehane, Jessica L. Rauh, Goeto Dantes, Hanna Alemayehu, Marshall Wallace, Irving J. Zamora, Kylie Callier, Bethany J. Slater, Derek Krinock, Robert Vandewalle, Amanda Witte, Katherine Flynn-O-Brien, Utsav M. Patwardhan, Romeo Ignacio, Lucas Neff, C
Topic overview
Pediatric choledocholithiasis is traditionally managed with an endoscopy-first approach, where Endoscopic Retrograde Cholangiopancreatography (ERCP) is performed before laparoscopic cholecystectomy (LC). However, ERCP carries risks such as pancreatitis, bleeding, infection, and perforation, and may even be an unnecessary procedure should stones pass spontaneously. An alternative surgery-first approach, utilizing intraoperative cholangiogram (IOC), laparoscopic common bile duct exploration (LCBDE), power flushing, and glucagon, may offer a more efficient treatment pathway.
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