Bulotta AL, Stern MV, Moneghini D, Parolini F, Bondioni MP, Missale G, Boroni G, Alberti D. Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature. World J Gastrointest Endosc 2021; 13(10): 529-542 [PMID: 34733413 DOI: 10.4253/wjge.v13.i10.529]
Corresponding Author of This Article
Filippo Parolini, MD, Doctor, Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, “Spedali Civili” Hospital, Brescia 25123, Italy. parfil@hotmail.it
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Oct 16, 2021; 13(10): 529-542 Published online Oct 16, 2021. doi: 10.4253/wjge.v13.i10.529
Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature
Anna Lavinia Bulotta, Maria Vittoria Stern, Dario Moneghini, Filippo Parolini, Maria Pia Bondioni, Guido Missale, Giovanni Boroni, Daniele Alberti
Anna Lavinia Bulotta, Maria Vittoria Stern, Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
Dario Moneghini, Guido Missale, Department of Digestive Endoscopy, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
Maria Pia Bondioni, Department of Pediatric Radiology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
Author contributions: Bulotta AL, Stern MV and Alberti D conceptualized and designed the study; Bulotta AL, Stern MV, Parolini F, Boroni G and Alberti D were involved in medical care of the patients; Bondioni MP performed radiological investigations; Missale G and Moneghini D performed endoscopic treatment; Stern MV, Bulotta AL and Parolini F collected the clinical data from patients and from literature; All authors contributed equally to preparation of the manuscript and reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: Authors certify that there is no conflict of interest related to the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Filippo Parolini, MD, Doctor, Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, “Spedali Civili” Hospital, Brescia 25123, Italy. parfil@hotmail.it
Received: January 28, 2021 Peer-review started: January 28, 2021 First decision: March 31, 2021 Revised: April 30, 2021 Accepted: August 2, 2021 Article in press: August 2, 2021 Published online: October 16, 2021
Abstract
BACKGROUND
Duodenal duplications are rare congenital anomalies of the gastrointestinal tract. As the periampullary variant is much rarer, literature is scant and only few authors have reported their experience in diagnosis and treatment, particularly with operative endoscopy.
CASE SUMARY
To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts, focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations. The pediatric periampullary duodenal duplication cyst literature is reviewed. We conducted a systematic review according to the PRISMA guidelines. The PubMed database was searched for original studies on “duodenal duplication”, “periampullary duplication” or “endoscopic management” published since 1990, involving patients younger than 18 years of age. Eligible study designs were case report, case series and reviews. We analyzed the data and reported the results in table and text. Fifteen eligible articles met the inclusion criteria with 16 patients, and analysis was extended to our additional 4 cases. Median age at diagnosis was 13.5 years. Endoscopic treatment was performed in 10 (50%) patients, with only 2 registered complications.
CONCLUSION
Periampullary duodenal duplication cysts in pediatric patients are very rare. Our experience suggests that an accurate preoperative assessment is critical. In the presence of sludge or stones inside the duplication, endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree. Endoscopic treatment resulted in a safe, minimally invasive and effective treatment. In periampullary duodenal duplication cyst endoscopically treated children, long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.
Core Tip: Periampullary duodenal duplications are extremely uncommon in children. The authors report a series of 4 patients and provide a detailed literature review.
