Related Experiment Video
Updated: Apr 25, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China: a multicenter
Guoliang Qiao1, Long Li, Suolin Li
1Department of Pediatric Surgery, The Capital Institute of Pediatrics, No. 2 Ya Bao Road, Beijing, 100020, People's Republic of China.
Insights
Laparoscopic hepaticojejunostomy (LH) is a safe and effective treatment for children with choledochal cysts (CDC). This multicenter study of 956 patients shows reliable long-term outcomes and low surgical morbidity.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Choledochal cyst (CDC) is a rare congenital anomaly of the biliary tract.
- Laparoscopic hepaticojejunostomy (LH) has emerged as a feasible surgical approach for pediatric CDC.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic hepaticojejunostomy (LH) for treating choledochal cysts (CDC) in a large multicenter pediatric cohort.
Main Methods:
- Retrospective analysis of medical records from 956 pediatric patients who underwent LH for CDC across seven academic institutions (June 2001–May 2012).
- Follow-up assessments included ultrasonography, upper gastrointestinal contrast studies, and laboratory tests.
Main Results:
- Operative times for LH significantly decreased over time across all participating centers.
- Postoperative complications were generally low, including bile leaks (1.5%), anastomotic stenosis (0.6%), and Roux loop obstruction (0.8%).
- Two mortalities occurred (0.2%), attributed to hyperkalemia and postoperative bleeding. Mean follow-up was 5.7 years.
Conclusions:
- Laparoscopic hepaticojejunostomy (LH) is a safe and effective treatment for pediatric choledochal cysts (CDC).
- LH offers reliable middle- and long-term outcomes with low surgical morbidity in children.
- This multicenter series supports LH as a viable surgical option for CDC.
Aims:
Laparoscopic hepaticojejunostomy (LH) for children with choledochal cyst (CDC) has become feasible and popular recently. The purpose of this study is to evaluate the safety and efficacy of LH for CDC in a large multicenter series.
Patients And Methods:
Medical records of 956 consecutive patients who underwent LH for CDC at seven academic institutions from June 2001 to May 2012 were retrospectively analyzed. Ultrasonography, upper gastrointestinal contrast studies, and laboratory tests were performed during the follow-up period.
Results:
A total of 956 patients of CDC treated with LH were identified and included in this study. Of these patients, there were no significant differences in age, gender ratio, and the subtypes of CDC among the seven centers. The operative time of all patients decreased significantly as time went by. Interestingly, the centers that began to perform LH earlier, like cohort A, B, and C, took much more time in the initial cases than the later centers. The postoperative complications included 12 (1.3 %) intra-abdominal fluid collection, 6 (0.6 %) anastomotic stenosis, 14 (1.5 %) bile leak, 8 (0.8 %) Roux loop obstruction and 4 (0.4 %) gastrointestinal bleeding, and one case developed intrahepatic stone formation; two mortalities occurred; one died of hyperkalemia, and the other one died of postoperative bleeding. No other complication occurred during the mean follow-up of 5.7 years (ranged from 4 month to 11 years).
Conclusions:
We reported a multi-institutional series of LH in children with CDC. Our findings suggested that LH represents a feasible treatment option for CDC by offering reliable middle and long-term outcome, low surgical morbidity.
