Implementation of a Surgery-first Approach to Pediatric Choledocholithiasis

In brief

This study compares surgery-first versus endoscopy-first approaches for clearing bile duct stones in pediatric patients. The authors evaluate whether primary cholecystectomy with intraoperative exploration yields better outcomes than initial ERCP followed by surgery.

• Choledocholithiasis requires CBD clearance via ERCP or IOC with CBDE during cholecystectomy.
• Surgery-first approach (primary cholecystectomy with IOC/CBDE) may improve outcomes vs. primary ERCP in pediatric patients.
• Intraoperative cholangiogram allows real-time CBD assessment and stone clearance during the same procedure.
• Comparing primary cholecystectomy to primary ERCP helps define optimal treatment sequencing for pediatric CBD stones.

Written by the GCMD Library team from the article.