Laparoscopic excision of congenital choledochal cyst in children and modified hepaticojejunostomy with an unequal length of the jejunal loop

Introduction: Complete excision biliary-enteric reconstruction is necessary for a congenital choledochal cyst (CC) to prevent recurrent cholangitis, acute pancreatitis, and cholangiocarcinoma. Among various reconstructions, this study aims to evaluate the therapeutic effect of unequal length jejunal loop for the biliary reconstruction of congenital choledochal cyst. Method: The clinical data of 56 cases of congenital choledochal cyst treated in the pediatric surgery department of Children's Hospital Affiliated to Zheng Zhou University were retrospectively analyzed. All cases were treated with choledochal cyst resection and unequal length jejunal loop biliary reconstruction, including 51 cases with laparoscopic surgery and 5 cases with traditional surgery. Result: Choledochal cyst resection and unequal length jejunal loop biliary reconstruction were successfully completed in all cases. One case of laparoscopic operation developed biliary fistula on the 3rd day after the operation, and the biliary fistula healed after conservative treatment for 8 days. The other cases recovered smoothly without obvious complications. No contrast agent bile loop reflux was found in upper gastrointestinal angiography. Conclusion: The modified jejunal loop biliary reconstruction has many advantages over the traditional biliary reconstruction, which is worthy of clinical application.

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Diagnosis and treatment of congenital choledochal cyst: 20 years’ experience in China

World Journal of Gastroenterology ◽

10.3748/wjg.v7.i5.732 ◽

2001 ◽

Vol 7 (5) ◽

pp. 732 ◽

Cited By ~ 37

Author(s):

Liu-Bin Shi ◽

Shu-You Peng ◽

Xing-Kai Meng ◽

Cheng-Hong Peng ◽

Ying-Bin Liu ◽

...

Keyword(s):

Choledochal Cyst ◽

Diagnosis And Treatment ◽

Congenital Choledochal Cyst

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Laparoscopic treatment of congenital choledochal cyst and hepaticojejunostomy with extracorporeal Roux-en-Y anastomosis: technical aspects and early experience with three cases

La Pediatria Medica e Chirurgica ◽

10.4081/pmc.2016.125 ◽

2016 ◽

Vol 38 (2) ◽

Cited By ~ 2

Author(s):

Mario Lima ◽

Tommaso Gargano ◽

Giovanni Ruggeri ◽

Francesca Destro ◽

Michela Maffi

Keyword(s):

Choledochal Cyst ◽

Laparoscopic Approach ◽

Rare Condition ◽

Early Experience ◽

Cyst Excision ◽

Intrahepatic Bile Ducts ◽

First Case ◽

Laparoscopic Excision ◽

Extracorporeal Anastomosis ◽

Laparoscopic Removal

Choledochal cyst (CDC) is a congenital dilatation of the extra and/or intrahepatic bile ducts and it is a rare condition in western countries. Classical treatment consists of cyst excision and hepaticojejunostomy. The first case of a laparoscopic CDC excision was described in 1995 and since that time an increasing number of institutions have adopted this technique, with good success. We describe our early experience of 3 cases of CDC treated with laparoscopic approach. We used a 10 mm umbilical port for the camera, and four 3-5 mm operative ports. We performed the laparoscopic removal of the cyst and gallbladder, videoassisted preparation of the Roux-en-Y loop and laparoscopic hepaticjejunostomy. No post-operative complications occurred. Laparoscopic excision of CDCs has been supposed to give better observation, a better cosmetic result, potentially less postoperative pain, and a shorter recovery. The main argument for performing an extracorporeal anastomosis is that it decreases the operative time. We recommend caution to prevent injury to the pancreatic duct and biliary structures during dissection and anastomosis. Lifelong surveillance is mandatory, even after resection of the choledochal cyst.

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Congenital choledochal cyst

Paediatrica Indonesiana ◽

10.14238/pi13.1.1973.31-4 ◽

1973 ◽

Vol 13 (1) ◽

pp. 31

Author(s):

Heyder Bin Heyder

Keyword(s):

Bile Duct ◽

Choledochal Cyst ◽

Medical Literature ◽

Personal Contact ◽

Congenital Choledochal Cyst ◽

Unusual Condition ◽

The Pacific ◽

The Common ◽

The Right ◽

Upper Abdomen

Although congenital choledochal cyst, a localized dilatation of the common bile duct, is an unusual condition in many countries, it should be expected in any infant who presents the triad of jaundice, tumor and pain in the right upper abdomen. Not less than 500 cases have been reported in the medical literature. Recently it is pointed out, that the congenital chledochal cyst is more common in Japan than in Europe or American countries. A personal contact with the Japanese delegation attending the meeting of the Pacific Association of Pediatric Surgeons in Vancouver, May 1971, confirmed it.

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