title: Surgical treatment of congenital biliary duct cyst.
abstract: BACKGROUND
  It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision.
  
  
  METHODS
  From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ≤ 3 years), the immaturity group (3 < age ≤ 18 years), and the maturity group (age > 18 years), and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups.
  
  
  RESULTS
  Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p < 0.05) (lowest in the infant group), and intraoperative blood loss also had apparent diversity (p < 0.05). Furthermore, long-term outcomes (secondary cholangiolithiasis, stoma stenosis and cholangiocarcinoma) showed no significant difference between different groups (p > 0.05).Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05) between the laparoscopic and the open surgery groups.
  
  
  CONCLUSIONS
  We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.
authors.affiliation: Institute of Hepatobiliary Surgery of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: De-chun
authors.initials: DC
authors.lastname: Wang
authors.forename: Zi-pei
authors.initials: ZP
authors.lastname: Liu
authors.forename: Zhi-hua
authors.initials: ZH
authors.lastname: Li
authors.forename: Da-jiang
authors.initials: DJ
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.forename: Shu-guo
authors.initials: SG
authors.lastname: Zheng
authors.forename: Yu
authors.initials: Y
authors.lastname: He
authors.forename: Ping
authors.initials: P
authors.lastname: Bie
authors.forename: Shu-guang
authors.initials: SG
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000150:complications* / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult