Mei Diao1, Long Li, Wei Cheng. 1. Capital Institute of Pediatrics, Beijing, People's Republic of China.
Abstract
BACKGROUND: Single-incision laparoscopic surgery has been increasingly adopted in pediatric surgery. Nevertheless, its feasibility and safety in neonates with congenital biliary malformations is unclear. This study reports successful single-incision laparoscopic hepaticojejunostomy (SILH) for neonates with extrahepatic biliary cystic lesions. METHODS: Ten neonates with extrahepatic biliary cystic lesions (choledochal cyst/correctable biliary atresia: 6/4) who underwent SILH between May 2011 and September 2011 were reviewed. Ultrasonography, upper gastrointestinal contrast studies, and laboratory tests were performed during the follow-up period. RESULTS: Mean operative time, postoperative hospital stay, time to full feeding, and duration of drainage were comparable to our historic open-control groups of 15 neonates with choledochal cysts and 7 patients with correctable biliary atresia. Median follow-up duration was 6.0 months. They regularly took medical treatments during the follow-up periods. The jaundice subsided or liver function was normalized within 3 months postoperatively. So far, no mortality or morbidity of cholangitis, bile leak, anastomotic stenosis, and intrahepatic reflux were encountered. CONCLUSIONS: In experienced hands, SILH for neonates with extrahepatic biliary cystic lesions is feasible and safe. It provides a new alternative for neonatal hepatobiliary surgery.
BACKGROUND: Single-incision laparoscopic surgery has been increasingly adopted in pediatric surgery. Nevertheless, its feasibility and safety in neonates with congenital biliary malformations is unclear. This study reports successful single-incision laparoscopic hepaticojejunostomy (SILH) for neonates with extrahepatic biliary cystic lesions. METHODS: Ten neonates with extrahepatic biliary cystic lesions (choledochal cyst/correctable biliary atresia: 6/4) who underwent SILH between May 2011 and September 2011 were reviewed. Ultrasonography, upper gastrointestinal contrast studies, and laboratory tests were performed during the follow-up period. RESULTS: Mean operative time, postoperative hospital stay, time to full feeding, and duration of drainage were comparable to our historic open-control groups of 15 neonates with choledochal cysts and 7 patients with correctable biliary atresia. Median follow-up duration was 6.0 months. They regularly took medical treatments during the follow-up periods. The jaundice subsided or liver function was normalized within 3 months postoperatively. So far, no mortality or morbidity of cholangitis, bile leak, anastomotic stenosis, and intrahepatic reflux were encountered. CONCLUSIONS: In experienced hands, SILH for neonates with extrahepatic biliary cystic lesions is feasible and safe. It provides a new alternative for neonatal hepatobiliary surgery.
Authors: Ma Lishuang; Chen Zhen; Qiao Guoliang; Zhang Zhen; Wang Chen; Li Long; Liu Shuli Journal: Pediatr Surg Int Date: 2015-01-28 Impact factor: 1.827