BACKGROUND: Single-incision laparoscopy has recently become popular in pediatric surgery. Yet there has been no report on its application in the management of choledochal cysts (CDC). The current series is the first study to evaluate the safety and efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) for CDC in children. METHODS: We reviewed 19 children who underwent SILH between April and June 2011. Early postoperative and follow-up results were compared with our historical controls. RESULTS: The median follow-up period was 3 months. Two procedures were converted to the conventional four-port laparoscopic hepaticojejunostomies. SILH was successfully completed in 17 patients (median age: 3.00 years; F/M: 12/5). Early in the series, one patient developed bile leak, which stopped spontaneously after 10 days of drainage. The mean operative time of the SILH group did not differ from that of our conventional laparoscopic hepaticojejunostomy (CLH) controls (3.06 vs. 3.04 h, P = 0.909). The average postoperative hospital stay, time to full feed, and duration of drainage in the SILH group were comparable to our historical controls of CLH (P = 0.056, 0.472, 0.619, respectively). CONCLUSIONS: In experienced hands, SILH is safe and its short-term results are comparable to CLH. It potentially provides a viable surgical alternative for CDC.
BACKGROUND: Single-incision laparoscopy has recently become popular in pediatric surgery. Yet there has been no report on its application in the management of choledochal cysts (CDC). The current series is the first study to evaluate the safety and efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) for CDC in children. METHODS: We reviewed 19 children who underwent SILH between April and June 2011. Early postoperative and follow-up results were compared with our historical controls. RESULTS: The median follow-up period was 3 months. Two procedures were converted to the conventional four-port laparoscopic hepaticojejunostomies. SILH was successfully completed in 17 patients (median age: 3.00 years; F/M: 12/5). Early in the series, one patient developed bile leak, which stopped spontaneously after 10 days of drainage. The mean operative time of the SILH group did not differ from that of our conventional laparoscopic hepaticojejunostomy (CLH) controls (3.06 vs. 3.04 h, P = 0.909). The average postoperative hospital stay, time to full feed, and duration of drainage in the SILH group were comparable to our historical controls of CLH (P = 0.056, 0.472, 0.619, respectively). CONCLUSIONS: In experienced hands, SILH is safe and its short-term results are comparable to CLH. It potentially provides a viable surgical alternative for CDC.
Authors: Yuk Him Tam; Kim Hung Lee; Jennifer Dart Yin Sihoe; Kin Wai Chan; Sing Tak Cheung; Kristine Kit Yi Pang Journal: J Pediatr Surg Date: 2010-12 Impact factor: 2.545
Authors: Yury Kozlov; Vladimir Novozhilov; Polina Baradieva; Pavel Krasnov; Konstantin Kovalkov; Oliver J Muensterer Journal: World J Clin Pediatr Date: 2015-11-08