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Updated: Jun 24, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic excision of choledochal cyst and Roux-en-Y hepaticojejunostomy in symptomatic neonates
Shu-Li Liu1, Long Li, Wen-Ying Hou
1Department of Pediatric Surgery, Peking University First Hospital, Beijing 100034, China.
Insights
Laparoscopic choledochal cyst excision is safe and feasible in neonates. This minimally invasive approach reduces surgical trauma and normalizes liver function, avoiding complications associated with choledochal cysts.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hepatobiliary Surgery
Background:
- Choledochal cysts necessitate surgical removal to prevent complications like cholangitis.
- Laparoscopic excision is established in adults and older children.
- Safety and efficacy in neonates remain unclear.
Purpose of the Study:
- To evaluate the safety and feasibility of laparoscopic choledochal cyst excision in symptomatic neonates.
- To assess outcomes and complications associated with the procedure in this age group.
Main Methods:
- A retrospective review of 9 neonates with choledochal cysts who underwent laparoscopic excision.
- Roux-en-Y hepaticojejunostomy performed with extracorporeal fashioning and intracorporeal anastomosis.
- Follow-up averaged 26 months.
Main Results:
- Median operation time was 3.6 hours with no operative complications or conversions.
- Minimal blood loss, uneventful recovery, and a median hospital stay of 6 days.
- Normalized liver function tests within 3–16 weeks postoperatively, with no late complications.
Conclusions:
- Laparoscopic excision of choledochal cysts is feasible and safe in neonates.
- The procedure effectively curtails cyst complications and reverses liver function derangements.
- Minimally invasive surgery offers reduced trauma compared to open procedures.
Purpose:
Choledochal cysts require surgical excision, preferably before the onset of cholangitis. Recently, it has become feasible to accomplish the excision laparoscopically in adults and older children. Yet, whether laparoscopic excision of choledochal cyst can be performed safely in symptomatic neonates with choledochal cyst is unclear. We herewith reviewed our experience of laparoscopic excision of choledochal cysts in neonates.
Methods:
We managed 9 neonates with choledochal cysts between April 2003 and February 2007. The choledochal cysts were excised laparoscopically. The Roux-en-Y hepaticojejunostomy was fashioned extracorporeally by exteriorizing the jejunum through the extended umbilical port site. End-to-side anastomosis between the common hepatic duct stump and Roux loop was carried out intracorporeally. The patients were followed up for an average of 26 months.
Results:
The patients presented with jaundice, pale stool, and deranged liver function tests. The diagnosis was confirmed with ultrasonography postnatally. The median operation time was 3.6 hours. There was no operative complication and no conversion. The blood loss was minimal. The recovery was uneventful, and the median hospital stay was 6 days. The liver function tests normalized 3 to 16 weeks postoperatively. No complication was detected at the follow-up visits.
Conclusions:
Our preliminary results show that laparoscopic excision of choledochal cyst and Roux-en-Y hepaticojejunostomy in neonates is both feasible and safe. It curtails further complication of the cysts and reverses the derangement of liver function. In addition, the laparoscopic approach minimizes surgical trauma.