title: Laparoscopic management for prenatally diagnosed choledochal cysts.
abstract: OBJECTIVE
  The aim of this study was to validate our laparoscopic management strategy for asymptomatic and symptomatic patients with prenatally diagnosed choledochal cysts (CCs).
  
  
  METHODS
  Thirteen prenatally diagnosed CC patients from 1997 to 2015 were included. Seven patients (1997-2008) underwent open surgery (OS group), and 6 (2009-2015) underwent laparoscopic surgery (LS group). In the asymptomatic patients, LS was performed when the patients weighed over 5 kg. When the patient had clinical manifestations, early LS was performed irrespective of body weight. A retrospective comparison was conducted between the LS and OS groups in terms of the operative time, blood loss, postoperative fasting period, hospital stay, and intra- and postoperative complications.
  
  
  RESULTS
  There was no difference between the demographics of both groups. The operative time was significantly longer (380 vs. 288 min) and blood loss was significantly lower (4 vs. 30 mL) in the LS group. Additionally, the postoperative fasting period (3 vs. 6 days) and hospital stay (11 vs. 20 days) were significantly shorter in the LS group. Intraoperative events and early postoperative complications were not encountered in either group. Small bowel obstruction requiring surgery occurred in two patients, 10 and 13 years after OS, respectively.
  
  
  CONCLUSIONS
  LS is as safe and feasible as OS in small children with prenatally diagnosed CC, although sufficient pediatric laparoscopic expertise is mandatory.
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan. n-urushihara@i.shizuoka-pho.jp.
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamoto
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015529:Choledochal Cyst / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Choledochal cyst; Laparoscopy; Neonate; Prenatal diagnosis