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Updated: May 15, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Management of choledochal cyst: Evolution with antenatal diagnosis and laparoscopic approach
Abdelmounim Cherqaoui1, Mirna Haddad, Celine Roman
1Department of Pediatric Surgery, Hopital d'enfants de la Timone, Marseille 13385, France.
Insights
Laparoscopic excision of choledochal cysts (CC) in infants is safe and effective, offering comparable outcomes to open surgery. Early laparoscopic intervention for prenatally diagnosed CCs is recommended to prevent complications.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Choledochal cysts (CC) are congenital biliary anomalies. Laparoscopic excision with hepaticojejunostomy is increasingly used in pediatric patients, including neonates.
- Prenatal diagnosis of CC is rising, but optimal timing for surgical intervention in infants remains debated.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic management of choledochal cysts (CC) in children.
- To compare laparoscopic and open surgical approaches for CC treatment, emphasizing antenatal diagnosis and early intervention.
Main Methods:
- Retrospective study of 19 patients (2 weeks to 16 years) undergoing hepaticojejunostomy for CC between 2000-2009.
- Comparison of 10 open procedures (Group A) versus 9 laparoscopic procedures (Group B), analyzing pre- and post-operative data.
Main Results:
- Laparoscopic group (B) had a higher proportion of prenatally diagnosed cases (4/9) and fewer pre-operative complications (22% vs. 60% in Group A).
- Operative time was longer in the laparoscopic group (288.56 min vs. 206 min, p=0.041). Postoperative complications were similar, with one biliary leakage in Group B requiring re-operation.
- Patients in the open group (A) were older and had longer hospital stays and return to bowel function times.
Conclusions:
- Laparoscopic excision of CC in infancy is technically feasible, safe, and effective, with low morbidity.
- Outcomes are comparable to open surgery, supporting early laparoscopic intervention for antenatally diagnosed CCs to minimize complications.
Background/Aim:
Laparoscopic excision of a choledochal cyst (CC) with hepaticojejunostomy gained a wide acceptance in the treatment of children even in neonatal period. Although, the use of prenatal diagnostic techniques causes a significant increase in antenatal diagnosis of CC, the time of surgical intervention during infancy is still controversial. A retrospective study was performed to evaluate the results of laparoscopic management of CC with special emphasis on antenatal diagnosis and treatment, and to compare the results with open procedure.
Materials And Methods:
The patients who were diagnosed with choledochal cyst and underwent either open or laparoscopic hepaticojejunostomy in two centres, hopital d'enfant de La Timone from Marseille and hopital Robert Debre from Paris between November 2000 and December 2009 were included in the study. The data obtained from medical reports were evaluated for sex, time of antenatal diagnosis, age at time of operation, operative time, time of postoperation.
Results:
A total of 19 hepaticojejunostomy were performed, including 10 open procedures (group A), and 9 laparoscopic procedures (group B, 4 were diagnosed prenatally, without conversion to open procedure). There were 3 boys and 16 girls, ranging in age from 2 weeks to 16 years. Patients in the group A were older than patients in the group B. The mean hospital stay and time to return of bowel fuction was longer in the group B. there were 60% of pre-operative complications in group A versus 22% in group B. There was one postoperative complications in group B (biliary leakage nedeed redo surgery). No significant differences were found between different parameters except for operative time (288.56 min in the group B versus 206 min in the group A. (p = 0.041)).
Conclusions:
Our initial experience indicates that the laparoscopic approach in infancy is technically feasible, safe, and effective, with a low morbidity and a comparable outcome to the open approach. Therefore, we propose a laparoscopic approach for antenatally diagnosed CC as early as possible, before the onset of complications.