J Minim Invasive Surg.  2017 Jun;20(2):58-62. 10.7602/jmis.2017.20.2.58.

Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Series

• Koo EJ
• Jung E
• Choi SO

• KMID: 2389138
• DOI: http://doi.org/10.7602/jmis.2017.20.2.58

Abstract

PURPOSE
Choledochal cysts are congenital dilatations of the biliary tract and are generally surgically excised. Laparoscopic total excision of choledochal cysts and hepaticojejunal biliary tract reconstruction has gained acceptance among pediatric surgeons. We report our early experience with this procedure.
METHODS
From May 2013 to April 2016, 10 consecutive patients (7 females and 3 males) underwent laparoscopic choledochal cyst excision and hepaticojejunostomy at our center. We retrospectively reviewed their medical records for age, sex, clinical symptoms, Todani classification, anomalous pancreaticobiliary duct union, operative time, starting day for enteral feeding, complications, and hospital stay.
RESULTS
The median patient age was 22 months. Four patients were aged less than 6months, 3 of whom received prenatal diagnosis using ultrasonography. Patients presented with abdominal pain, jaundice, vomiting and fever. No abdominal mass was palpated in any patient. One patient was classified as Todani type Ia, 4 as Ic, and 5as IVa. Six patients had an anomalous pancreaticobiliary duct union. The mean operative time was 319.4 minutes. There were no surgery-related complications. Sips of water were allowed from mean postoperative day 2.4 and regular diet from mean postoperative day 3.4. The mean hospital stay was 6.5 days.
CONCLUSION
Laparoscopic excision of choledochal cyst and hepaticojejunostomy in children is feasible with favorable cosmesis.

Keyword

Choledochal cyst; Laparoscopy; Child

MeSH Terms

Abdominal Pain
Biliary Tract
Child
Choledochal Cyst*
Classification
Diet
Dilatation
Enteral Nutrition
Female
Fever
Humans
Jaundice
Laparoscopy
Length of Stay
Medical Records
Operative Time
Prenatal Diagnosis
Retrospective Studies
Surgeons
Ultrasonography
Vomiting
Water
Water