Go Ohba1, Hiroshi Yamamoto2, Masato Nakayama3, Shohei Honda4, Akinobu Taketomi5. 1. Department of Surgery, Tenshi Hospital, North 12 East 3-1-1, Higashi-ku, Sapporo 065-8611, Japan. Electronic address: grancanaria.0925@gmail.com. 2. Department of Surgery, Tenshi Hospital, North 12 East 3-1-1, Higashi-ku, Sapporo 065-8611, Japan. Electronic address: battsu-h@gamma.ocn.ne.jp. 3. Department of Surgery, Tenshi Hospital, North 12 East 3-1-1, Higashi-ku, Sapporo 065-8611, Japan. Electronic address: nakajama@live.jp. 4. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan. Electronic address: s-honda@med.hokudai.ac.jp. 5. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
Abstract
BACKGROUND: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs. METHODS: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B). The operative time, intraoperative bleeding, length of stay, and postoperative complications were analyzed. RESULTS: Group A comprised 6 patients (2 males, 4 females; mean age, 29months), and Group B comprised 26 patients (2 males, 24 females; mean age, 41months). All patients underwent single-stage complete excision with Roux-en-Y hepaticojejunostomy. There were no significant differences in the operative time, bleeding, and/or length of stay. There were no operative deaths or complications such as anastomosis leakage or postoperative cholangitis, but a pancreatic fistula developed in one patient in Group A and two in Group B. CONCLUSION: Single-stage excision for a perforated CC is feasible if the patient's condition is stable. LEVELS OF EVIDENCE: Treatment Study, LEVELIII.
BACKGROUND: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs. METHODS: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B). The operative time, intraoperative bleeding, length of stay, and postoperative complications were analyzed. RESULTS: Group A comprised 6 patients (2 males, 4 females; mean age, 29months), and Group B comprised 26 patients (2 males, 24 females; mean age, 41months). All patients underwent single-stage complete excision with Roux-en-Y hepaticojejunostomy. There were no significant differences in the operative time, bleeding, and/or length of stay. There were no operative deaths or complications such as anastomosis leakage or postoperative cholangitis, but a pancreatic fistula developed in one patient in Group A and two in Group B. CONCLUSION: Single-stage excision for a perforated CC is feasible if the patient's condition is stable. LEVELS OF EVIDENCE: Treatment Study, LEVELIII.