Mei Diao1, Long Li2, Qi Li1, Mao Ye1, Wei Cheng3. 1. Department of Pediatric Surgery, Capital Institute of Pediatrics, 2 Ya Bao Road, Beijing 100020, PR China. 2. Department of Pediatric Surgery, Capital Institute of Pediatrics, 2 Ya Bao Road, Beijing 100020, PR China. Electronic address: lilong22@hotmail.com. 3. Department of Paediatrics and Department of Surgery, Southern Medical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 3168, Australia; Department of Surgery, Beijing United Family Hospital, PR China. Electronic address: wei.cheng@monash.edu.
Abstract
BACKGROUND/ PURPOSE: Giant choledochal cyst (CDC) is thought to be a challenge for one-stage single-incision laparoscopic hepaticojejunostomy (SILH). We herewith designed the strategies for SILH in surgical management of giant CDC children, and reported its outcomes. METHODS: Twenty-eight patients with giant CDCs successfully underwent SILH between April 2011 and October 2013. With guidance of an extra-long 5-mm 30° laparoscope, anterior cyst wall was punctured extra-corporeally using a 20-gauge angiocatheter. Cyst content was evacuated to create working space. A series of trans-abdominal retraction sutures were placed through serosa of gallbladder fundus, common hepatic duct and proximal to distal portion of anterior cyst wall to facilitate dissection. Cyst excision and hepaticojejunostomy was performed. RESULTS: Mean age at operation was 6.24 months. Mean operative time was 3.18 h, significantly shorter than 6.3 h in our historical group undergone conventional laparoscopic hepaticojejunostomy. No blood transfusion was required. Post-operative recovery was comparable to that of our historical CLH controls. Median follow-up period was 24 months. No mortality or morbidities of anastomotic stenosis, bile leak, cholangitis or pancreatic leak was observed. Liver function normalized post-operatively. CONCLUSIONS: Following the strategy, SILH for giant CDCs is safe and one can achieve outcomes comparable to those of CLH in experience hands.
BACKGROUND/ PURPOSE: Giant choledochal cyst (CDC) is thought to be a challenge for one-stage single-incision laparoscopic hepaticojejunostomy (SILH). We herewith designed the strategies for SILH in surgical management of giant CDC children, and reported its outcomes. METHODS: Twenty-eight patients with giant CDCs successfully underwent SILH between April 2011 and October 2013. With guidance of an extra-long 5-mm 30° laparoscope, anterior cyst wall was punctured extra-corporeally using a 20-gauge angiocatheter. Cyst content was evacuated to create working space. A series of trans-abdominal retraction sutures were placed through serosa of gallbladder fundus, common hepatic duct and proximal to distal portion of anterior cyst wall to facilitate dissection. Cyst excision and hepaticojejunostomy was performed. RESULTS: Mean age at operation was 6.24 months. Mean operative time was 3.18 h, significantly shorter than 6.3 h in our historical group undergone conventional laparoscopic hepaticojejunostomy. No blood transfusion was required. Post-operative recovery was comparable to that of our historical CLH controls. Median follow-up period was 24 months. No mortality or morbidities of anastomotic stenosis, bile leak, cholangitis or pancreatic leak was observed. Liver function normalized post-operatively. CONCLUSIONS: Following the strategy, SILH for giant CDCs is safe and one can achieve outcomes comparable to those of CLH in experience hands.
Authors: Justin T Huntington; Laura A Boomer; Victoria K Pepper; Karen A Diefenbach; Jennifer L Dotson; Benedict C Nwomeh Journal: Pediatr Surg Int Date: 2016-02-13 Impact factor: 1.827
Authors: Laurens D Eeftinck Schattenkerk; Gijsbert D Musters; David J Nijssen; Wouter J de Jonge; Ralph de Vries; L W Ernest van Heurn; Joep P M Derikx Journal: Innov Surg Sci Date: 2021-08-17
Authors: Laurens D Eeftinck Schattenkerk; Gijsbert D Musters; David J Nijssen; Wouter J de Jonge; Ralph de Vries; L W Ernest van Heurn; Joep Pm Derikx Journal: Sci Rep Date: 2020-12-03 Impact factor: 4.379