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Hepaticojejunostomy after excision of choledochal cyst in two children with previous biliary surgery
1Department of Surgery, Ratchaburi Hospital, Ratchaburi, Thailand.
Insights
Hepaticojejunostomy Roux-en-Y is the preferred treatment for choledochal cysts in children, preventing complications. This surgical approach ensures long-term patient well-being and avoids risks associated with prior incomplete biliary surgeries.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Choledochal cysts pose risks of cholangitis, stones, and malignancy.
- Incomplete biliary surgeries can lead to complications.
- Roux-en-Y hepaticojejunostomy after total cyst excision is considered optimal.
Observation:
- Two pediatric patients presented with chronic abdominal pain after prior biliary surgery for choledochal cysts.
- One patient had cystojejunostomy without cholecystectomy; the other had cholecystectomy alone.
- Both patients underwent successful cyst excision and Roux-en-Y hepaticojejunostomy.
Findings:
- Postoperative follow-up of six and one year showed patients remained asymptomatic.
- The study highlights complications arising from previous inadequate surgical interventions.
- Successful outcomes support complete cyst excision with Roux-en-Y hepaticojejunostomy.
Implications:
- Reinforces Roux-en-Y hepaticojejunostomy as the gold standard for choledochal cyst treatment in children.
- Emphasizes the importance of complete cyst excision to prevent recurrence and complications.
- Suggests this approach minimizes risks of cholangitis, stone formation, and malignancy.
Abstract:
Hepaticojejunostomy Roux-en-Y after excision of choledochal cyst is the treatment of choice for children with choledochal cyst, to prevent the risk of postoperative cholangitis, stone formation and malignancy. The author reports two children with previous biliary surgery for choledochal cyst, one with cystojejunostomy without cholecystectomy and the other with cholecystectomy alone. Two children were admitted to the Pediatric Surgical Unit, Ratchaburi Hospital, with the complaint of chronic abdominal pain. After investigation the two children had cyst excision and hepaticojejunostomy Roux-en-Y. After six and one year follow-up the patients remain asymptomatic. The aim of this report was to show the complication of two previous biliary surgeries for choledochal cyst and support total cyst excision combined with hepaticojejunostomy Roux-en-Y being the treatment of choice for choledochal cyst.
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