Related Experiment Video
Updated: Dec 14, 2025
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Treatment of complex complications after choledochal cyst resection by multiple minimal invasive therapies: A case
Hoa Viet Nguyen1, Dang Hai Do2, Hung Van Nguyen3
1Department of Paediatric Surgery, Vietnam Germany Hospital, Hanoi, Viet Nam.
Insights
Complex postoperative complications following choledochal cyst resection were successfully managed using a combination of minimally invasive techniques. This case highlights the importance of step-up management for challenging biliary conditions.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Choledochal cysts are rare congenital bile duct dilations causing persistent symptoms.
- Postoperative complications are frequent after choledochal cyst resection, necessitating advanced management strategies.
Observation:
- A 10-year-old patient experienced severe complications including cholangitis, bilioenteric stenosis, and remnant duct cystolithiasis post-resection.
- Multiple interventions were required, including balloon dilation, percutaneous transhepatic biliary drainage, ERCP, and laparoscopic surgery.
Findings:
- A multidisciplinary, step-up approach involving various minimally invasive techniques successfully resolved complex postoperative complications.
- The patient achieved complete recovery without further complications.
Implications:
- Minimally invasive procedures are crucial for managing complex choledochal cyst complications, aiming for symptom relief and biliary drainage.
- Even with experienced surgeons, vigilance for postoperative complications and readiness for reoperation are essential.
Introduction:
Choledochal cyst is a rare benign congenital dilation of the bile duct, which causes recurring disturbing symptoms without totally resection. Nonetheless, postoperative complications are still a common issue. A step up management for patients with complex complications is required to address the problem.
Case Presentation:
We report a 10-year-old child who suffered complex postoperative complications after choledochal cyst resection at the age of 5, including cholangitis, bilioenteric stenosis and cystolithiasis in remnant intrapancreatic duct cyst. She occasionally endured episodes of epigastric pain, fever and jaundice afterwards. As the symptoms and recurrent rate were worsen over time, the patient was admitted multiple times and various approaches (balloon dilation, percutaneous transhepatic biliary drainage, endoscopic retrograde cholangiopancreatography and laparoscopic surgery) were applied. Afterwards, patient recovered and discharged without any complications.
Conclusion:
Our case presented sophisticated complications relating to choledochal cyst that were successfully treated by a combination of modern minimal invasive techniques. Despite operated by experienced surgeons, the post-op complications are still a concerned problem due to difficult laparoscopic techniques, injuries of hepatic artery, infection and risk of malignancy. We suggested that minimal-invasive procedures should be considered first with the aim of relieving symptoms, biliary drainage and preparing for the reoperation.
