title: Laparoscopic complete cyst excision and hepaticoduodenostomy for choledochal cyst: early results in 74 cases.
abstract: OBJECTIVE
  To report the technical details and early outcomes of complete laparoscopic cyst excision and hepaticoduodenostomy for choledochal cyst.
  
  
  METHODS
  The operation was performed using four ports. The cystic duct was identified and divided. The liver was elevated by two stay sutures: one on the round ligament, and the other on the distal cystic duct. The choledochalcyst was isolated and removed completely and the duodenum was mobilized. Hepaticoduodenostomy was constructed 2 cm distal to the pylorus using two running sutures with 5-0 polydioxane sutures.
  
  
  RESULTS
  From January to December 2007, 74 patients were operated. There were 59 girls and 15 boys. Ages ranged from 2.5 months to 16 years old. The diameter of the cyst ranged from 10 mm to 184 mm. The operating time ranged from 90 minutes to 340 minutes (mean: 186 minutes). Conversion to open surgery was required in one patient. Blood transfusion was required in four patients. Postoperative anastomotic leakage occurred in three patients, resolving spontaneously in two patients and requiring a second operation in the third.Postoperative hospital stay ranged from 4 days to 21 days (average: 6.6 days). Follow-up from 3 months to 12 months was obtained in 56 patients (75.5%). Of these patients, cholangitis occurred in three patients (5.3%) and gastritis due to bilious reflux in eight patients (14.3%).
  
  
  CONCLUSIONS
  Laparoscopic complete cyst excision and hepaticoduodenostomy is a safe and physiologic procedure for choledochal cyst.
authors.affiliation: Department of Surgery, National Hospital of Pediatrics, Hanoi, Vietnam. liemnhp@hotmail.com
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Liem
authors.forename: Le Anh
authors.initials: le A
authors.lastname: Dung
authors.forename: Tran Ngoc
authors.initials: TN
authors.lastname: Son
mesh_terms: D000293:Adolescent; D001803:Blood Transfusion; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000601:surgery*; D004385:Duodenostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome