Tran Ngoc Son1, Nguyen Thanh Liem, Vu Manh Hoan. 1. Surgical Department, National Hospital of Pediatrics, 18/879 La Thanh Road, Hanoi, 100000, Vietnam, drtranson@yahoo.com.
Abstract
PURPOSE: To report the authors' experience in the management of perforated choledochal cyst with bile peritonitis (PCC) in children. METHODS: Medical records of all children undergoing surgery for PCC at our hospital from May, 2005 to January, 2013 were reviewed. RESULTS: Twenty seven patients were identified, with a median age of 2 years. The clinical manifestations were abdominal pain (96.3 %), abdominal distention (92.6 %), vomiting (88.9 %), jaundice (74.1 %), fever (70.4 %), acholic stool (51.8 %), abdominal tenderness (92.6 %), peritoneal signs (74.1 %), and palpable mass (18.5 %). Duration of the acute symptoms ranged from 1 to 30 days (median 3 days). Median size of the choledochal cysts was 3 cm (range 1.5-18 cm). Before January 2008, four cases were treated by two-staged surgery and only one case by one-staged surgery. Since then, all remaining 22 cases were treated by the one-staged surgery. There was no anastomotic leakage and all patients were discharged in good health. The mean postoperative stay was 7.6 ± 2.5 days for the one-staged group. No complication was noted at a median follow-up of 24 months. CONCLUSIONS: One-staged definitive repair is feasible, safe and should be the treatment of choice for most cases of childhood PCC in experienced centers.
PURPOSE: To report the authors' experience in the management of perforated choledochal cyst with bile peritonitis (PCC) in children. METHODS: Medical records of all children undergoing surgery for PCC at our hospital from May, 2005 to January, 2013 were reviewed. RESULTS: Twenty seven patients were identified, with a median age of 2 years. The clinical manifestations were abdominal pain (96.3 %), abdominal distention (92.6 %), vomiting (88.9 %), jaundice (74.1 %), fever (70.4 %), acholic stool (51.8 %), abdominal tenderness (92.6 %), peritoneal signs (74.1 %), and palpable mass (18.5 %). Duration of the acute symptoms ranged from 1 to 30 days (median 3 days). Median size of the choledochal cysts was 3 cm (range 1.5-18 cm). Before January 2008, four cases were treated by two-staged surgery and only one case by one-staged surgery. Since then, all remaining 22 cases were treated by the one-staged surgery. There was no anastomotic leakage and all patients were discharged in good health. The mean postoperative stay was 7.6 ± 2.5 days for the one-staged group. No complication was noted at a median follow-up of 24 months. CONCLUSIONS: One-staged definitive repair is feasible, safe and should be the treatment of choice for most cases of childhood PCC in experienced centers.
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