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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic management of abdominal lymphatic cyst in children
Ngoc Son Tran1, Thanh Liem Nguyen
1National Hospital of Pediatrics, Hanoi, Vietnam. drtranson@yahoo.com
Insights
Laparoscopic surgery (LS) is a safe and effective approach for treating pediatric abdominal lymphatic cysts (ALC). This minimally invasive technique offers good outcomes with low recurrence rates for children with ALC.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Abdominal lymphatic cysts (ALC) are rare congenital anomalies.
- Management of ALC in children can be challenging.
- Laparoscopic surgery (LS) offers a minimally invasive alternative to open procedures.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of laparoscopic surgery (LS) for pediatric abdominal lymphatic cysts (ALC).
- To assess the outcomes and complication rates associated with LS in managing ALC in children.
Main Methods:
- Retrospective review of medical records of pediatric patients who underwent LS for ALC.
- Detailed description of laparoscopic techniques, including port placement and cyst management.
- Analysis of operative time, complications, hospital stay, and recurrence rates.
Main Results:
- Forty-seven pediatric patients with ALC were included.
- Laparoscopic cyst excision was performed in 76.6% of cases; 17.0% required laparoscopy-assisted bowel resection.
- Mean operative time was 79 minutes, with no intra- or postoperative complications and a short hospital stay (3.8 days).
- A low recurrence rate of 2.1% was observed in complex cases.
Conclusions:
- Laparoscopic management of ALC in children is safe, feasible, and effective.
- LS should be considered the primary treatment option for most pediatric ALC cases.
- Minimally invasive approaches lead to favorable patient outcomes.
Purpose:
The aim of this study is to investigate the feasibility and effectiveness of laparoscopic surgery (LS) in management of abdominal lymphatic cyst (ALC) in children.
Subjects And Methods:
Medical records of all patients undergoing LS for ALC at the National Hospital of Pediatrics, Hanoi, Vietnam, from May 2007 to June 2011 were reviewed. For LS, one umbilical port of 10 mm and up to three other 3-5-mm ports were used. Cystic fluid was aspirated prior to removal of the cyst. When intestinal resection was indicated, the mesenteric cyst with the bowel loop was delivered out of the abdomen through a minimally enlarged umbilical incision; resection of the intestinal segment together with the cyst and the bowel anastomosis were both performed extracorporally.
Results:
Forty-seven patients were identified, with a mean age of 4.3 ± 3.7 years. The most common symptoms were abdominal pain (72.3%) and abdominal distention (34.0%). Four patients presented with acute abdomen due to infection or hemorrhage of the cyst. Mean size of the ALC was 9.5 ± 5.5 cm (range, 3.4-30 cm). In 12 cases the ALC was omental, and in 35 cases it was mesenteric. Laparoscopic cyst excision was performed in 36 cases (76.6%) versus laparoscopy-assisted bowel resection en bloc with the cyst in 8 cases (17.0%); in 3 patients (6.4%), conversion to open surgery was required. Mean operative time was 79 ± 39 minutes. There were no intra- or postoperative complications. Mean length of hospital stay after laparoscopic management was 3.8 ± 1.6 days. The results of pathologic investigation showed benign cystic lymphangioma in all cases. During follow-up ranging from 1 month to 4 years, recurrence was seen in 1 patient (2.1%) with complex mesenteric cyst. All other patients remained in good health.
Conclusions:
Laparoscopic management is safe, feasible, and effective and should be the treatment of choice for most cases of ALC in children.