Laparoscopic management for prenatally diagnosed choledochal cysts

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.