DOI: http://dx.doi.org/10.18203/2349-2902.isj20193331

Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: a single-institution prospective cohort study

Nguyen Thanh Xuan, Ho Huu Thien, Phan Hai Thanh, Pham Anh Vu, Nguyen Huu Son, Dang Nhu Thanh, Nguyen Du Vinh, Pham Nhu Hiep

Abstract


Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.

Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.

Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.

Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases.

 


Keywords


Laparoscopic excision, Roux-en-Y hepaticojejunostomy, Choledochal cyst, Children

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References


Soreide K, Korner H, Havnen J, Soreide JA. Bile duct cysts in adults. Br J Surg. 2004;91(12):1538-48.

Tang W, Dong K, Liu G, Cui X, Zheng S. The Clinical Characters of Congenital Choledochal Cysts in Perinatal Patients: A Retrospective Analysis in a Single Institution. Am J Perinatol. 2015;32(9):853-8.

Kayaalp C, Soyer V, Ersan V, Aydin C, Karagul S. Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy. Ulus Cerrahi Derg. 2016;32(2):152-4.

Diao M, Li L, Cheng W. Laparoscopic versus Open Roux-en-Y hepatojejunostomy for children with choledochal cysts: intermediate-term follow-up results. Surg Endosc. 2011;25(5):1567-73.

Liu Y, Yao X, Li S, Liu W, Liu L, Liu J. Comparison of therapeutic effects of laparoscopic and open operation for congenital choledochal cysts in adults. Gastroenterol Res Pract. 2014;2014:670260.

Liem NT. Laparoscopic surgery for choledochal cysts. J Hepatobiliary Pancreat Sci. 2013;20(5):487-91.

Duan X, Mao X, Jiang B, Wu J. Totally laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for choledochal cyst in adults: a single-institute experience of 5 years. Surg Laparosc Endosc Percutan Tech. 2015;25(2):e65-8.

Xuan NT, Hiep PN, Thien HH, Vu PA, Thanh PH, Khanh LD, et al. Laparoscopic excision of choledochal cyst in Hue Central Hospital. Vietnam Laparoscopic Surgery Endoscopy J. 2013;1(3):22-5.

Terblanche J, Worthley CS, Spence RA, Krige JE. High or low hepaticojejunostomy for bile duct strictures? Surgery. 1990;108(5):828-34.

Wiseman K, Buczkowski AK, Chung SW, Francoeur J, Schaeffer D, Scudamore CH. Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg. 2005;189(5):527-31.

Lee SE, Jang JY, Lee YJ, Choi DW, Lee WJ, Cho BH, et al. Choledochal cyst and associated malignant tumors in adults: a multicenter survey in South Korea. Arch Surg. 2011;146(10):1178-84.

Choi SB, Choi SY. Current status and future perspective of laparoscopic surgery in hepatobiliary disease. Kaohsiung J Med Sci. 2016;32(6):281-91.

Farello GA, Cerofolini A, Rebonato M, Bergamaschi G, Ferrari C, Chiappetta A. Congenital choledochal cyst: video-guided laparoscopic treatment. Surg Laparosc Endosc. 1995;5(5):354-8.

Sheng Q, Lv Z, Xu W, Xiao X, Liu J, Wu Y. Reoperation after cyst excision with hepaticojejunostomy for choledochal cysts: our experience in 18 cases. Med Sci Monit. 2017;23:1371-7.

Huang CS, Huang CC, Chen DF. Choledochal cysts: differences between pediatric and adult patients. J Gastrointest Surg. 2010;14(7):1105-10.

Liem NT, Pham HD, Dung le A, Son TN, Vu HM. Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients. J Laparoendosc Adv Surg Tech A. 2012;22(6):599-603.

Tang ST, Yang Y, Wang Y, Mao YZ, Li SW, Tong QS, et al. Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases. Surg Endosc. 2011;25(2):416-22.

Ono S, Fumino S, Shimadera S, Iwai N. Long-term outcomes after hepaticojejunostomy for choledochal cyst: a 10- to 27-year follow-up. J Pediatr Surg. 2010;45(2):376-8.

Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KKY, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study. J Pediatr Surg. 2011;46(4):662-5.

Acker SN, Bruny JL, Narkewicz MR, Roach JP, Rogers A, Karrer FM. Preoperative imaging does not predict intrahepatic involvement in choledochal cysts. J Pediatr Surg. 2013;48(12):2378-82.