Single-stage operation for perforated choledochal cyst

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Oncology

Background:

• The optimal surgical approach for perforated choledochal cysts (CCs) remains debated, with single-stage versus two-stage excision being compared.
• This study evaluates the safety and efficacy of single-stage excision for both perforated and non-perforated CCs.

Purpose of the Study:

• To compare the short-term outcomes and complications of single-stage complete excision for perforated versus non-perforated choledochal cysts.
• To assess the feasibility of single-stage excision in managing perforated CCs.

Main Methods:

• Retrospective review of medical records for patients treated for CCs between 2003 and 2016.
• Comparison of outcomes between patients with perforated CCs (Group A) and non-perforated CCs (Group B).
• Analysis included operative time, bleeding, length of stay, and postoperative complications.

Main Results:

• Single-stage complete excision with Roux-en-Y hepaticojejunostomy was performed in all patients.
• No significant differences were observed in operative time, bleeding, or length of stay between groups.
• While no operative deaths or major complications like anastomosis leakage or cholangitis occurred, pancreatic fistulas developed in one patient in Group A and two in Group B.

Conclusions:

• Single-stage excision is a feasible surgical option for perforated choledochal cysts in hemodynamically stable patients.
• The procedure demonstrated comparable short-term outcomes and acceptable complication rates relative to non-perforated CCs.