Shifting the pediatric choledocholithiasis paradigm: Development of a surgery-first clinical practice guideline at a tertiary children’s hospital

In brief

This article presents a novel surgery-first clinical practice guideline for managing choledocholithiasis in children, developed at a tertiary pediatric center. The paradigm shift challenges traditional ERCP-first approaches, offering an alternative treatment algorithm specifically designed for the pediatric population with biliary stones.

• Surgery-first approach for pediatric choledocholithiasis may reduce procedural burden compared to traditional ERCP-first strategies.
• Tertiary children's hospitals can develop institution-specific guidelines to standardize management of bile duct stones in children.
• Clinical practice guidelines help shift treatment paradigms by providing evidence-based frameworks for surgical decision-making.
• Multidisciplinary collaboration between surgery, gastroenterology, and radiology is essential for optimal choledocholithiasis management.
• Early surgical intervention may improve outcomes and reduce hospital length of stay in select pediatric patients with bile duct stones.

Written by the GCMD Library team from the article.