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J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):599-603. doi: 10.1089/lap.2012.0018. Epub 2012 Jun 12.

Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients.

Author information

1
Department of Surgery, National Hospital of Pediatrics, Hanoi, Vietnam. liemnhp@hotmail.com

Abstract

OBJECTIVE:

The aim of this study is to report early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 cases.

PATIENTS AND METHODS:

The operation was performed using four ports. The cystic duct was identified and divided. The liver was suspended by two stay-sutures: one on the round ligament and the other on the distal cystic duct. The choledochal cyst was isolated and removed completely, and biliary-digestive continuity was reestablished by hepaticoduodenostomy (HD) or hepaticojejunostomy (HJ).

RESULTS:

From January 2007 to June 2011, 400 patients were operated on. There were 305 girls and 95 boys. Ages ranged from 1 month to 16 years (mean, 47.5±2.1 months). Cystic excision and HD were performed in 238 patients and HJ in 162 patients. The mean operating time was 164.8±51 minutes for the HD group and 220±60 minutes for the HJ group. Conversion to open surgery was required in 2 patients. There were no perioperative deaths. Postoperative biliary leakage occurred in 8 patients (2%), resolving spontaneously in 7 and requiring a second operation in 1 patient. The mean postoperative hospital stay was 6.4±0.3 days for the HD group and 6.7±0.5 days for the HJ group. Follow-up between 5 months and 57 months postdischarge (mean, 24.2±2.7 months) was obtained in 342 patients (85.5%). Cholangitis occurred in 5 patients (1.5%) in the HD group and 1 patient (0.6%) in the HJ group. Gastritis due to bilious reflux was 3.8% in the HD group.

CONCLUSIONS:

Laparoscopic repair is a safe and effective procedure for choledochal cyst. The rate of cholangitis and anastomotic stenosis is low.

PMID:
22691183
DOI:
10.1089/lap.2012.0018
[Indexed for MEDLINE]

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