One-step endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy: A safe strategy in pediatrics.

Introduction: The incidence of choledocholithiasis in pediatrics has increased in the last 20 years. Treatment typically involves two procedures -endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC). The objective of this study was to demonstrate that conducting both procedures in a single step is safe in pediatric patients.

Material and methods: A prospective study was carried out in two Argentinian institutions over three years. Patients under 18 years of age diagnosed with choledocholithiasis were included. They were divided into two groups -surgery (one-step ERCP+LC) and control (two-step ERCP+LC).

Results: 42 patients were included. The surgery group consisted of 27 patients, whereas the control group was made up of 15 patients. Both groups were similar in terms of age and sex. The results showed that median anesthetic time was significantly shorter in the surgery group (120 minutes) than in the control group (150 minutes). 2 patients from the control group developed cholecystitis while awaiting LC.

Conclusions: Conducting ERCP+LC in a single step is safe in pediatric patients and can reduce anesthetic times as well as cholelithiasis morbidity and complications.