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 376

Special Issue Editors


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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

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

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Keywords

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

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Published Papers (1 paper)

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Research

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
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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
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