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A modified technique of single-incision laparoscopic hepaticojejunostomy for children with choledochal cysts

Di Xu1, Kunbin Tang1, Shaohua He2

  • 1Pediatrics Surgery Department, Fujian Provincial Hospital, Fuzhou, 350001, China.

BMC Surgery
|April 12, 2019
PubMed

Insights

This study introduces a modified laparoscopic technique for pediatric choledochal cyst excision, improving surgical view and enabling single-incision procedures. The method achieved excellent outcomes without complications, enhancing surgical efficiency.

Area of Science:

  • Pediatric surgery
  • Minimally invasive surgery
  • Gastrointestinal surgery

Background:

  • Choledochal cysts are congenital bile duct dilatations requiring surgical intervention.
  • Laparoscopic surgery offers advantages but can present challenges in visualization.
  • Optimizing the surgical view is crucial for safe and effective excision in pediatric patients.

Purpose of the Study:

  • To present a modified laparoscopic surgical technique for total excision of choledochal cysts in pediatric patients.
  • To optimize the surgical view during the procedure.
  • To evaluate the efficacy and safety of the modified technique.

Main Methods:

  • A total of 48 pediatric patients with choledochal cysts (Todani types I and IVa) were included.
  • The study utilized a transumbilical single-incision laparoscopic approach.
  • Diagnostic imaging included ultrasound, CT, and MRCP.

Main Results:

  • Total cystic excision with hepaticoenterostomy was successfully performed laparoscopically in all 48 cases.
  • The modified technique resulted in an average operative time of 200 minutes and minimal blood loss (9 ml).
  • No postoperative complications or abdominal effusion were reported during a 6-month follow-up.

Conclusions:

  • The modified laparoscopic technique provides a stabilized surgical view, reducing reliance on assistants.
  • It achieves comparable postoperative outcomes to conventional laparoscopic surgery for choledochal cyst excision.
  • This approach enhances surgical efficiency and safety in pediatric patients.
Abstract

Keywords:
AnastomosisCholedochal cystLaparoscopyMinimally invasive surgeryTransumbilical

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