title: Laparoscopic excision of a choledochal cyst in 82 consecutive patients.
abstract: BACKGROUND
  Despite it being a benign disease, a choledochal cyst must be removed with the gallbladder (GB) due to the risk of cancer in the biliary tract. Most patients are young females or children, all of whom express strong interest in the cosmetic results in addition to the complete resolution of their medical problems. Here, we introduce a laparoscopic management technique for a choledochal cyst.
  
  
  METHODS
  Between 2003 and 2011, we performed a laparoscopic choledochal cyst excision procedure on 82 patients using a four-hole method. There were three open-conversion cases, one case involving robotic surgery, and one case involving combined laparoscopic liver resection because the cyst had affected the liver. Excision of the cyst and anastomosis were performed laparoscopically. We will present our method with a video.
  
  
  RESULTS
  The mean operation time was 230 min. The estimated blood loss was 197 ml. The average hospital stay was 8.6 days. The most common complications were minor bile leakage (7 %) and fluid collection (2.5 %), both of which were managed conservatively.
  
  
  CONCLUSIONS
  Laparoscopic management can be a treatment of choice for the most instances of choledochal cyst considering its good cosmetic results and its feasible level of operative safety.
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. jangjy4@snu.ac.kr
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Mee Joo
authors.initials: MJ
authors.lastname: Kang
authors.forename: Wooil
authors.initials: W
authors.lastname: Kwon
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Ye Rim
authors.initials: YR
authors.lastname: Chang
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Ahn
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D015529:Choledochal Cyst / Q000601:surgery*; D002779:Cholestasis / Q000209:etiology; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology; D018450:Disease Progression; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000293:injuries; D010190:Pancreatic Neoplasms / Q000209:etiology; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012371:Robotics; D055815:Young Adult