Reply to Letter to the Editor by Rauh J, et al.

jpedsurg.org

The advent of laparoscopy represented a paradigm shift in the management of cholelithiais [1]. However progress with management of choledocolithiasis has proven to be more elusive and remains a challenge for most pediatric units. Jessica Ruah, et al., present their experience with trans-cystic CBD stone extraction, negating the requirement for subsequent or preceding ERCP in most cases, thus avoiding repeat anesthetics [2]. A failure rate of 14% is sited and the fallback option for these cases is an ERCP at a subsequent admission [2].

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Article · May 2024 · 1 min read

In brief

This letter discusses laparoscopic trans-cystic common bile duct stone extraction in pediatric patients as an alternative to ERCP, highlighting a 14% failure rate requiring subsequent endoscopic intervention. The technique aims to reduce repeat anesthetics in pediatric choledocolithiasis management.

Laparoscopic trans-cystic CBD stone extraction can avoid ERCP in most pediatric choledocolithiasis cases, reducing repeat anesthetics.
The technique has a reported 14% failure rate in pediatric patients.
Failed laparoscopic extraction cases require fallback ERCP at a subsequent admission.
Pediatric choledocolithiasis management remains challenging despite advances in minimally invasive techniques.

Written by the GCMD Library team from the article.

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