Laparoscopic excision of choledochal cysts in children: an intermediate-term report.
OBJECTIVE
To assess the intermediate-term result of the use of the minimally invasive technique in the treatment of choledochal cysts in children.


METHODS
This is a retrospective review of all cases of choledochal cyst treated in the tertiary referral centre. The surgical technique is described and all the medical records were reviewed to assess the intraoperative and postoperative complications and follow-up problems.


RESULTS
From October 2000 to April 2008, laparoscopic excision and reconstruction were attempted in 37 patients. Laparoscopic surgery was successfully performed in 34. Conversion was required in three patients due to oozing on cyst dissection (two) and bleeding from small bowel mesentry (one) during the early part of the series. Postoperative complications were observed in 15 patients including subhepatic collection (6), bile leakage (3), minor wound infection (4) and prolonged ileus (2). At a mean follow-up of 4.2 years, four patients developed surgical complications including intrahepatic ductal strictures in a type IV cyst (one), stump pancreatitis (one), terminal ileal obstruction from internal herniation (one) and cholangitis (one). The cosmetic result was good in all patients.


CONCLUSIONS
We conclude that laparoscopic excision and reconstruction can be safely performed in children with a choledochal cyst with satisfactory intermediate-term results.
Lee
Kim Hung
KH
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. drkhlee@hotmail.com
Tam
Y H
YH
Yeung
C K
CK
Chan
K W
KW
Sihoe
J D Y
JD
Cheung
S T
ST
Mou
J W C
JW
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007582:Jejunostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome