Totally Laparoscopic Cyst Excision and Roux-en-Y Hepaticojejunostomy for Choledochal Cyst in Adults: A Single-institute Experience of 5 Years. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Duan, Xiaohui; Mao, Xianhai; Jiang, Bo; Wu, Jinshu
• Is Part Of: Surgical laparoscopy endoscopy & percutaneous techniques. Volume 25:Issue 2(2015)
• Publication Date: 2015-04
• Subjects: choledochal cyst -- adult -- laparoscopy -- operation; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Endoscopy -- Periodicals; Laparoscopy -- Periodicals; 617.550597
• DOI: 10.1097/SLE.0000000000000091
• Languages: English
• ISSNs: 1530-4515

Abstract

Abstract : Purpose: The present study aimed to describe the authors' experience and the intermediate-term outcome for totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy at a single center in a 5-year period. Methods: We retrospectively analyzed the clinical data of totally laparoscopic choledochal cyst excision and Roux-en-Y hepatoenterostomy on 31 adult patients from January 2009 to November 2013. Results: Thirty-one cases successfully underwent totally laparoscopic choledochal cyst excision laparoscopy and Roux-en-Y hepatoenterostomy. The operation time varied from 200 to 360 minutes. The intraoperative blood loss was 50 to 210 mL. The patients passed flatus in 3.0±1.3 days. The mean time interval to resume oral intake from the time of surgery was 3.8±1.4 days. The duration of postoperative intravenous fluids was 4 to 11 days. Postoperative ambulation varied from 2 to 4 days. The duration of hospital stay was 4 to 13 days. Follow-up observations lasted 3 to 59 months and complications were noted in 4 patients. Of these patients, 1 patient suffered postoperative respiratory tract infection, 1 patient had an episode of adhesive small bowel obstruction, biliary leakage occurred in 1 patient, and 1 patient developed an anastomotic stoma stricture and cholangitis. There were no perioperative deaths. Conclusions: Totally laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is a safe, efficacious, and minimally invasive procedure for the most instances of adult choledochal cyst. The key of success is skilled laparoscopic skills, good team cooperation, and stapler anastomosis.