[Total cyst excision with ultrasonic scalpel under the laparoscope for choledochal cyst].
OBJECTIVE
To discuss the technique and its advantage on application of ultrasonic scalpel in laproscopic cyst excision with Roux-en-Y hepatoenterostomy.


METHODS
Forty-five cases were undergone laparoscopic cyst excision with Roux-en-Y hepatoenterostomy by ultrasonic scalpel. After intraoperative cholangiogram, the gallbladder and the dilated bile duct were completely excised by ultrasonic scalpel. Roux-en-Y hepatoenterostomy was performed extracorporeally through umbilical incision, then an end-to-side anastomosis was carried out intracorporeally.


RESULTS
All 45 cases were completely accomplished under laparoscope combined with ultrasonic scalpel. Median duration of operation was 4.2 h (3.5-6.0 h). Intraoperative bleeding was between 10-50 ml (median 15 ml). No complication were found during operation. All children were discharged in 3-9 d (median 5.5 d) after operation. Thirty-eight cases were followed up 1-18 months. No stenosis or ileus occurred. Liver functions were in normal level.


CONCLUSIONS
Total cyst excision with Roux-en-Y hepatoenterostomy by ultrasonic scalpel under the laparoscope was effective and safe for choledochal cyst. The most excellence was that clearly viewing during operation, less bleeding and injury, free of pain postoperation, microincision and scar.
Jia
Jun
J
Department of Pediatric Surgery, Peking University First Hospital, Beijing 100034, China.
Li
Long
L
Liu
Gang
G
Huang
Liu-ming
LM
D000713:Anastomosis, Roux-en-Y; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation*