Early complications after excision with hepaticoenterostomy for infants and children with choledochal cysts.
OBJECTIVE
To retrospectively study the early complications of excision with hepaticoenterostomy for infants and children with choledochal cysts.


METHODS
We analyzed 16 patients with early postoperative complications out of 173 patients with congenital choledochal cysts aged 27 days to 14 years (mean 2.4 years) who had undergone excisional procedures and biliary tract reconstruction.


RESULTS
The early complications included bile leakage (10 patients), abdominal wall dehiscence (3), and hepatic failure, pancreatic juice leakage and postoperative intussusception (each in 1) respectively. Three patients died from bile leakage and 1 from postoperative hepatic failure. No statistical differences were observed between the procedures of biliary tract reconstruction with jejunal segment interposition hepaticoduodenostomy and Roux-en-Y hepaticojejunostomy (P>0.75). The morbidity was significantly higher in infants below 1 year than in children (P<0.005). Prevention and treatment of the complications were discussed.


CONCLUSIONS
Bile leakage and abdominal wall dehiscence are major early postoperative complications. The morbidity of cholechal cysts is higher in infants than in children. Exploratory laparotomy should not be delayed when biliary leakage with diffuse peritonitis appears. The "tension suture in the fascial space of the abdominal wall" is useful to prevent and treat wound dehiscence.
Li
Min-Ju
MJ
Department of Pediatric Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. minjuli@mail.hz.zj.cn
Feng
Jie-Xiong
JX
Jin
Qi-Fei
QF
D000293:Adolescent; D001646:Bile / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects* / Q000401:mortality; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013997:Time Factors