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Children
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Advances and Controversies in Paediatric Gastrointestinal and Hepatobiliary Surgery: Update
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Advances and Controversies in Paediatric Gastrointestinal and Hepatobiliary Surgery: Update

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: 1 October 2025 | Viewed by 514

Special Issue Editors

Dr. Francisco Hernández Oliveros

E-Mail Website
Guest Editor
1. Department of Pediatric Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain
2. Institute for Health Research IdiPAZ, La Paz University Hospital, 28046 Madrid, Spain
Interests: paediatric transplantation; hepatobiliary surgery; liver transplantation; multivisceral transplantation
Special Issues, Collections and Topics in MDPI journals
Dr. Carlos Delgado-Miguel

E-Mail Website
Guest Editor
1. Department of Pediatric Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain
2. Institute for Health Research IdiPAZ, La Paz University Hospital, 28046 Madrid, Spain
Interests: robotic surgery; experimental surgery; gastrointestinal surgery

Special Issue Information

Dear Colleagues,

The field of pediatric gastrointestinal and hepatobiliary surgery care is rapidly expanding thanks to advancements in intraoperative lesion identification and accumulated experience in robotic surgery, as well as the improved pre- and postoperative care of these patients; however, more research is needed to optimize outcomes.

Pediatric gastrointestinal and liver surgery includes different surgical procedures that are the main indication for surgery within the pediatric population, both emergency and elective. The minimally invasive laparoscopic approach has become the mainstay in recent years, although robotic surgery is beginning to be integrated.

The focus of this Special Issue is on all aspects of pediatric gastrointestinal and hepatobiliary surgery, addressing new advances and controversies. In particular, we aim to highlight novel and ongoing research in relation to new intraoperative visualisation techniques, such as fluorescent markers and advances in robotic surgery (both gastrointestinal and robotic), as well as improvements and advances in the pre- and postoperative care of complex patients requiring this type of surgery.

Dr. Francisco Hernández Oliveros
Dr. Carlos Delgado-Miguel
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • paediatric surgery
  • hepatobiliary surgery
  • gastrointestinal surgery
  • indocyanine green
  • robotic surgery

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Published Papers (2 papers)

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13 pages, 1484 KiB  
Article
Forme Fruste Choledochal Cysts in Children: Clinical Presentation and Treatment Outcomes—A Retrospective Multicenter Study
by Aleksandar Sretenović, Milan Slavković, Dragana Vujović, Polina Pavićević, Nenad Zdujić, Dražen Budimir and Zenon Pogorelić
Children 2025, 12(6), 689; https://doi.org/10.3390/children12060689 - 28 May 2025
Cited by 1 | Viewed by 422
Abstract
Purpose: Forme fruste choledochal cyst (FFCC) is a choledochal cyst with minimal or no dilatation of the extrahepatic bile duct (EHBD) and is usually associated with an anomalous pancreaticobiliary junction (APBJ). While sharing similar symptoms, inflammation, and malignant potential with classic biliary [...] Read more.
Purpose: Forme fruste choledochal cyst (FFCC) is a choledochal cyst with minimal or no dilatation of the extrahepatic bile duct (EHBD) and is usually associated with an anomalous pancreaticobiliary junction (APBJ). While sharing similar symptoms, inflammation, and malignant potential with classic biliary cysts, FFCC is often overlooked on ultrasound. This paper aims to present the experience of two tertiary pediatric centers in managing FFCC. Methods: In this retrospective study, the clinical data of pediatric patients treated for FFCC at two tertiary pediatric surgical centers between 1 January 2008 and 31 December 2023 were analyzed. The primary outcome was the clinical success of the surgical procedure, defined by the resolution of symptoms and the absence of major complications. Secondary outcomes included postoperative complications, type and duration of surgical procedures, and length of hospital stay. All patients underwent biliary reconstruction via either Roux-en-Y hepatico-jejunostomy or hepatico-duodenostomy. Clinical outcomes, including postoperative complications and patient follow-up, were evaluated. Results: Fourteen children (9 girls, 5 boys; aged 18 months to 12 years) underwent surgical treatment of FFCC. The mean age at surgery was 5.3 ± 3.8 years, and the mean diameter of the common bile duct was 7.9 ± 1.2 mm. Thirteen patients underwent Roux-en-Y hepatico-jejunostomy, and one underwent hepatico-duodenostomy. Over a mean follow-up period of 6.2 ± 3.6 years, no cholangitis or anastomotic stricture cases were observed. Two patients (14.3%) experienced minor wound infections managed conservatively. Conclusions: FFCC remains a diagnostic challenge due to its subtle imaging findings and non-specific clinical presentation. However, once identified, surgical excision with biliary reconstruction, most commonly via Roux-en-Y hepatico-jejunostomy, is a safe and effective treatment with excellent long-term outcomes. Given the potential for serious complications if left untreated, FFCC should be actively considered in pediatric patients with unexplained pancreatitis or biliary symptoms, even in the absence of overt ductal dilatation. Full article
(This article belongs to the Special Issue Advances and Controversies in Paediatric Gastrointestinal and Hepatobiliary Surgery: Update)
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18 pages, 655 KiB  
Systematic Review
Indocyanine Green Fluorescence Navigation in Pediatric Hepatobiliary Surgery: Systematic Review
by Carlos Delgado-Miguel, Javier Arredondo-Montero, Julio César Moreno-Alfonso, Isabella Garavis Montagut, Marta Rodríguez, Inmaculada Ruiz Jiménez, Noela Carrera, Pablo Aguado Roncero, Ennio Fuentes, Ricardo Díez and Francisco Hernández-Oliveros
Children 2025, 12(7), 950; https://doi.org/10.3390/children12070950 - 18 Jul 2025
Abstract
Introduction: Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is now widely regarded as a valuable aid in decision-making for complex hepatobiliary procedures, with increasing support from recent studies. Methods: We performed a systematic review following PRISMA guidelines, utilizing PubMed, CINAHL, [...] Read more.
Introduction: Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is now widely regarded as a valuable aid in decision-making for complex hepatobiliary procedures, with increasing support from recent studies. Methods: We performed a systematic review following PRISMA guidelines, utilizing PubMed, CINAHL, and EMBASE databases to locate studies on the perioperative use ICG in pediatric hepatobiliary surgeries. Two independent reviewers assessed all articles for eligibility based on predefined inclusion criteria. We collected data on study design, patient demographics, surgical indications, ICG dosing, timing of ICG injection, and perioperative outcomes. Results: Forty-three articles, including 930 pediatric patients, from 1989 to 2025 met the inclusion criteria for narrative synthesis in our systematic review, of which 22/43 (51.2%) were retrospective studies, 15/43 were case reports (34.9%), 3/43 (7.0%) were experimental studies, and the other three were prospective comparative studies (7.0%). The current clinical applications of ICG in hepatobiliary pediatric surgery include bile duct surgery (cholecystectomy, choledochal cyst, biliary atresia), reported in 17 articles (39.5%), liver tumor resection, reported in 15 articles (34.9%), liver transplantation, reported in 6 articles (14.6%), and liver function determination, reported in 5 articles (12.2%). Conclusions: ICG fluorescence navigation in pediatric hepatobiliary surgery is a highly promising and safe technology that allows for the intraoperative localization of anatomic biliary structures, aids in the identification and resection of liver tumors, and can accurately determine hepatic function. The lack of comparative and prospective studies, and the variability of the dose and timing of administration are the main limitations. Full article
(This article belongs to the Special Issue Advances and Controversies in Paediatric Gastrointestinal and Hepatobiliary Surgery: Update)
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