Wang YS, Hou M, Li ZY, Du ZJ, Liu JY. Therapeutic endoscopic retrograde cholangiopancreatography for giant bile duct stones in a child: A case report. World J Gastrointest Endosc 2026; 18(8): 118395 [DOI: 10.4253/wjge.118395]
Corresponding Author of This Article
Yue-Sheng Wang, Director, Department of Gastroenterology, Children’s Hospital Affiliated to Zhengzhou University, No. 33 East Longhu Outer Ring Road, Jinshui District, Zhengzhou 450000, Henan Province, China. wangyueshengys@126.com
Research Domain of This Article
Gastroenterology & Hepatology
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case-report
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Wang YS, Hou M, Li ZY, Du ZJ, Liu JY. Therapeutic endoscopic retrograde cholangiopancreatography for giant bile duct stones in a child: A case report. World J Gastrointest Endosc 2026; 18(8): 118395 [DOI: 10.4253/wjge.118395]
World J Gastrointest Endosc. Aug 16, 2026; 18(8): 118395 Published online Aug 16, 2026. doi: 10.4253/wjge.118395
Therapeutic endoscopic retrograde cholangiopancreatography for giant bile duct stones in a child: A case report
Yue-Sheng Wang, Miao Hou, Zi-Ying Li, Zhen-Jia Du, Jing-Yu Liu
Yue-Sheng Wang, Miao Hou, Zi-Ying Li, Zhen-Jia Du, Jing-Yu Liu, Department of Gastroenterology, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, Henan Province, China
Co-first authors: Yue-Sheng Wang and Miao Hou.
Author contributions: Wang YS and Hou M contributed equally to this article, they are the co-first authors of this manuscript; Hou M, Li ZY, Du ZJ, and Liu JY contributed to the discussion and design of the manuscript and edited the pictures; and all authors thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: During the early stage of literature editing and translation, I relied on software like ChatGPT, Grammarly, and DeepL for assistance in language polishing and translation. Only the corresponding tools are used to polish the language to make it read more smoothly.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yue-Sheng Wang, Director, Department of Gastroenterology, Children’s Hospital Affiliated to Zhengzhou University, No. 33 East Longhu Outer Ring Road, Jinshui District, Zhengzhou 450000, Henan Province, China. wangyueshengys@126.com
Received: January 7, 2026 Revised: March 6, 2026 Accepted: July 16, 2026 Published online: August 16, 2026 Processing time: 221 Days and 23.7 Hours
Abstract
BACKGROUND
Therapeutic endoscopic retrograde cholangiopancreatography for giant common bile duct stones with pancreaticobiliary maljunction (PBM) in children remains challenging. As a congenital anomaly, PBM is characterized by anatomical variants that may predispose affected children to recurrent pancreatitis and adversely affect growth and development.
CASE SUMMARY
A 6-year-old boy was admitted with nonprojectile vomiting and intermittent abdominal pain that had begun one week before admission. Yellowing of the skin and sclerae developed four days before admission followed by fever with a peak temperature of 38.8 ℃ and lethargy two days before admission. No pruritus, joint swelling or pain, diarrhea, bloody stools, abdominal distension, rash, or petechiae was reported. After admission, abdominal color ultrasound and magnetic resonance cholangiopancreatography were performed. Laboratory testing revealed a white blood cell count of 16.3 × 109/L, a neutrophil percentage of 91.5%, and a C-reactive protein level of 68.68 mg/L. The clinical diagnoses included acute suppurative cholangitis, biliary pancreatitis, common bile duct stones, PBM, and pancreas divisum. Symptoms were relieved after endoscopic retrograde cholangiopancreatography-based stone extraction and biliary decompression.
CONCLUSION
In this case, an individualized endoscopic stone-extraction strategy combined with endoscopic sphincterotomy was successfully used to remove the biliary stones and relieve the obstruction. The patient’s clinical symptoms resolved rapidly after the procedure, thereby providing favorable conditions for subsequent definitive surgery.
Core Tip: This case describes the successful therapeutic endoscopic retrograde cholangiopancreatography-based extraction of giant common bile duct stones in a child with concomitant pancreaticobiliary maljunction and pancreas divisum. A precisely tailored endoscopic approach can achieve effective biliary decompression and rapid symptom resolution while avoiding urgent surgery. This report supports the feasibility and safety of endoscopic retrograde cholangiopancreatography for themanagement of complex pediatric biliary anomalies.
