Xiaohui Duan1, Xianhai Mao, Bo Jiang, Jinshu Wu. 1. Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha, Hunan Province, People's Republic of China.
Abstract
PURPOSE: The present study aimed to describe the authors' experience and the intermediate-term outcome for totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy at a single center in a 5-year period. METHODS: We retrospectively analyzed the clinical data of totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy on 31 adult patients from January 2009 to November 2013. RESULTS: Thirty-one cases successfully underwent totally laparoscopic choledochal cyst excision laparoscopy and Roux-en-Y hepatoenterostomy. The operation time varied from 200 to 360 minutes. The intraoperative blood loss was 50 to 210 mL. The patients passed flatus in 3.0 ± 1.3 days. The mean time interval to resume oral intake from the time of surgery was 3.8 ± 1.4 days. The duration of postoperative intravenous fluids was 4 to 11 days. Postoperative ambulation varied from 2 to 4 days. The duration of hospital stay was 4 to 13 days. Follow-up observations lasted 3 to 59 months and complications were noted in 4 patients. Of these patients, 1 patient suffered postoperative respiratory tract infection, 1 patient had an episode of adhesive small bowel obstruction, biliary leakage occurred in 1 patient, and 1 patient developed an anastomotic stoma stricture and cholangitis. There were no perioperative deaths. CONCLUSIONS: Totally laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is a safe, efficacious, and minimally invasive procedure for the most instances of adult choledochal cyst. The key of success is skilled laparoscopic skills, good team cooperation, and stapler anastomosis.
PURPOSE: The present study aimed to describe the authors' experience and the intermediate-term outcome for totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy at a single center in a 5-year period. METHODS: We retrospectively analyzed the clinical data of totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy on 31 adult patients from January 2009 to November 2013. RESULTS: Thirty-one cases successfully underwent totally laparoscopic choledochal cyst excision laparoscopy and Roux-en-Y hepatoenterostomy. The operation time varied from 200 to 360 minutes. The intraoperative blood loss was 50 to 210 mL. The patients passed flatus in 3.0 ± 1.3 days. The mean time interval to resume oral intake from the time of surgery was 3.8 ± 1.4 days. The duration of postoperative intravenous fluids was 4 to 11 days. Postoperative ambulation varied from 2 to 4 days. The duration of hospital stay was 4 to 13 days. Follow-up observations lasted 3 to 59 months and complications were noted in 4 patients. Of these patients, 1 patient suffered postoperative respiratory tract infection, 1 patient had an episode of adhesive small bowel obstruction, biliary leakage occurred in 1 patient, and 1 patient developed an anastomotic stoma stricture and cholangitis. There were no perioperative deaths. CONCLUSIONS: Totally laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is a safe, efficacious, and minimally invasive procedure for the most instances of adult choledochal cyst. The key of success is skilled laparoscopic skills, good team cooperation, and stapler anastomosis.
Authors: Georgios Antonios Margonis; Gaya Spolverato; Yuhree Kim; Hugo Marques; George Poultsides; Shishir Maithel; Luca Aldrighetti; Todd W Bauer; Nicolas Jabbour; T Clark Gamblin; Kevin Soares; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2014-12-18 Impact factor: 3.452