Magnetic resonance cholangiopancreatoscopy with 3D-reconstruction in pediatric cystic dilation surgery

Aim. To evaluate the potential of magnetic resonance (MR) cholangiopancreatoscopy with 3D- reconstruction in planning the scope and features of laparoscopic interventions in children with cystic bile duct dilation.

Materials and methods. MR cholangiopancreatoscopy with 3D-reconstruction was perfomed in 73 children with cystic bile duct dilatations. Children ranged in age from 5 days to 17 years. All patients underwent laparoscopic excision of cystically altered extrahepatic bile ducts with formation of biliodigestive anastomosis.

Results. The performed MR cholangiopancreatoscopy with 3D-reconstruction detected spherical and spindle cystic dilation of the bile ducts in 30 (41.1%) and 43 (58.9%) children, respectively. In 20 (27.4%) children with intrahepatic duct trifurcation, biliodigestive anastomosis included both lobar hepatic and aberrant ducts. In 3 (4.1%) cases of lobar ductal stenosis, ductoplasty was performed to widen the area of biliodigestive anastomosis. MR cholangiopancreatoscopy with 3D-reconstructions in 2 (2.7%) patients identified the aberrant right hepatic artery.

Conclusion. For planning the scope of surgery, children with cystic dilation of the bile ducts should undergo MR cholangiopancreatoscopy with 3D-reconstruction. The method may be proposed as the primary one for preoperative laparoscopic planning.

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