Collaboration first: Rethinking the surgery-first approach for pediatric choledocholithiasis

In brief

This commentary challenges a surgery-first approach for pediatric bile duct stones, advocating instead for collaborative decision-making between surgery and gastroenterology. The authors critique limitations in recent data suggesting ERCP overuse and emphasize the importance of multidisciplinary evaluation in managing pediatric choledocholithiasis.

• Surgery-first approach for pediatric choledocholithiasis may not be optimal despite concerns about ERCP overuse
• Collaboration between gastroenterology and surgery is essential when managing pediatric bile duct stones
• ERCP has an established role in pediatric choledocholithiasis that should not be dismissed based on limited data
• Treatment decisions should be individualized rather than adopting blanket surgery-first protocols
• Multidisciplinary discussion is needed before changing standard pediatric choledocholithiasis management

Written by the GCMD Library team from the article.