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Correlation of ectopic distal location of papilla of Vater and clinical characteristics in pediatric choledochal cysts

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Abstract

Purpose

Ectopic distal location of papilla of Vater (EDLPV) is an obvious pathological feature of choledochal cyst (CDC). This study aimed to investigate the correlation between EDLPV and clinical characteristics of CDCs.

Methods

Three groups were studied: Group 1 (G1), papilla in the middle third of second part of duodenum (n = 38); Group 2 (G2), papilla from the distal third of second part to the beginning of third part of duodenum (n = 168); Group 3 (G3), papilla from the middle of third part to fourth part of duodenum (n = 121). Relative variables among three groups were compared.

Results

Compared with G1 and G2, G3 patients had the largest cysts (relative diameter: 1.18 vs. 1.60 vs. 2.62, p < 0.001), the youngest age (20.52 vs. 19.47 vs. -3.40 months, p < 0.001), the highest rate of prenatal diagnosis (26.32% vs. 36.31% vs. 62.81%, p < 0.001), the lowest occurrence of protein plugs in common channel (44.74% vs. 38.69% vs. 16.53%, p < 0.001), and the most elevated total bilirubin level (7.35 vs. 9.95 vs. 28.70 μmol/L, p < 0.001). Prenatally diagnosed G3 patients had heavier liver fibrosis than G2 (13.16% vs. 1.67%, p = 0.015).

Conclusion

The more distal papilla location, the more severe clinical characteristics of CDCs, suggesting a crucial role in its pathogenesis.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China

    Suyun Chen, Tong Yin, Long Li, Mei Diao & Ting Huang

  2. Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China

    Suyun Chen, Tong Yin, Long Li & Mei Diao

  3. Department of Pediatric Surgery, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Beijing, China

    Long Li

  4. Children’s Hospital Capital Institute of Pediatrics, Graduate School of Peking Union Medical College, Beijing, China

    Ting Huang

Authors
  1. Suyun Chen
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  2. Tong Yin
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  3. Long Li
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  4. Mei Diao
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  5. Ting Huang
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Contributions

Mrs. Suyun Chen had primary responsibility for protocol development, enrollment, preliminary data analysis and writing the manuscript. Mr. Tong Yin participated in the development of the protocol and contributed to the writing of the manuscript. Mr. Ting Huang participated in the collection of data. Dr. Long Li and Dr. Mei Diao supervised the design and execution of the study, performed the final data analyses and contributed to the writing of the manuscript. All authors reviewed the manuscript.

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Correspondence to Long Li.

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Chen, S., Yin, T., Li, L. et al. Correlation of ectopic distal location of papilla of Vater and clinical characteristics in pediatric choledochal cysts. Pediatr Surg Int 39, 201 (2023). https://doi.org/10.1007/s00383-023-05486-y

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