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Updated: Mar 24, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic management for prenatally diagnosed choledochal cysts
Mariko Matsumoto1, Naoto Urushihara2, Koji Fukumoto1
1Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.
Insights
Laparoscopic surgery (LS) for prenatally diagnosed choledochal cysts (CCs) in children is safe and feasible, offering shorter hospital stays and fasting periods compared to open surgery (OS). Pediatric laparoscopic expertise is essential for successful outcomes.
Area of Science:
- Pediatric Surgery
- Surgical Innovation
- Gastrointestinal Surgery
Background:
- Prenatally diagnosed choledochal cysts (CCs) require effective management strategies in pediatric patients.
- Evaluating surgical approaches for CCs is crucial for optimizing patient outcomes.
- Laparoscopic surgery (LS) presents a minimally invasive alternative to open surgery (OS) for CC treatment.
Purpose of the Study:
- To validate a laparoscopic management strategy for pediatric patients with prenatally diagnosed choledochal cysts (CCs).
- To compare the outcomes of laparoscopic surgery (LS) versus open surgery (OS) in managing CCs.
Main Methods:
- A retrospective study included 13 pediatric patients with prenatally diagnosed CCs.
- Seven patients underwent open surgery (OS) between 1997-2008, and six underwent laparoscopic surgery (LS) between 2009-2015.
- Comparison focused on operative time, blood loss, postoperative fasting, hospital stay, and complications.
Main Results:
- Laparoscopic surgery (LS) demonstrated significantly longer operative times but markedly reduced blood loss compared to open surgery (OS).
- Patients undergoing LS experienced significantly shorter postoperative fasting periods and hospital stays.
- No intraoperative or early postoperative complications were observed in either group; however, two patients who had OS later required surgery for small bowel obstruction.
Conclusions:
- Laparoscopic surgery (LS) is a safe and feasible option for managing prenatally diagnosed choledochal cysts (CCs) in pediatric patients.
- While LS offers advantages in recovery time, sufficient pediatric laparoscopic expertise is mandatory for successful implementation.
- The findings support LS as a viable alternative to OS, particularly in centers with advanced laparoscopic capabilities.
Purpose:
The aim of this study was to validate our laparoscopic management strategy for asymptomatic and symptomatic patients with prenatally diagnosed choledochal cysts (CCs).
Methods:
Thirteen prenatally diagnosed CC patients from 1997 to 2015 were included. Seven patients (1997-2008) underwent open surgery (OS group), and 6 (2009-2015) underwent laparoscopic surgery (LS group). In the asymptomatic patients, LS was performed when the patients weighed over 5 kg. When the patient had clinical manifestations, early LS was performed irrespective of body weight. A retrospective comparison was conducted between the LS and OS groups in terms of the operative time, blood loss, postoperative fasting period, hospital stay, and intra- and postoperative complications.
Results:
There was no difference between the demographics of both groups. The operative time was significantly longer (380 vs. 288 min) and blood loss was significantly lower (4 vs. 30 mL) in the LS group. Additionally, the postoperative fasting period (3 vs. 6 days) and hospital stay (11 vs. 20 days) were significantly shorter in the LS group. Intraoperative events and early postoperative complications were not encountered in either group. Small bowel obstruction requiring surgery occurred in two patients, 10 and 13 years after OS, respectively.
Conclusions:
LS is as safe and feasible as OS in small children with prenatally diagnosed CC, although sufficient pediatric laparoscopic expertise is mandatory.
