Related Experiment Video
Updated: Sep 7, 2025
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic definitive surgery for choledochal cyst is performed safely and effectively in infants
Takahisa Tainaka1, Chiyoe Shirota1, Wataru Sumida1
1Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Insights
Laparoscopic surgery for choledochal cyst (CC) is safe and effective in infants under one year old. This includes semi-emergency procedures, demonstrating feasibility even in critical situations for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Choledochal cysts (CC) in infants present surgical challenges due to small anatomy.
- Prenatal diagnosis necessitates timely intervention, often semi-emergency surgery, for symptomatic infants.
- Laparoscopic definitive surgery requires advanced pediatric surgical skills.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic definitive surgery for choledochal cysts in infants.
- To assess the feasibility of laparoscopic approaches, particularly in semi-emergency scenarios for infants.
- To compare outcomes between laparoscopic and open surgery in infants and between infant and older pediatric groups.
Main Methods:
- Retrospective comparison of surgical outcomes for 21 infants (<1 year) undergoing laparoscopic or open surgery for CC.
- Comparison of outcomes between infants (<1 year) and older children (3-5 years) undergoing laparoscopic CC surgery.
- Evaluation of surgical outcomes for semi-emergency (EM) versus elective (EL) laparoscopic CC surgery.
Main Results:
- Laparoscopic surgery in infants (<1 year) had longer operative times but significantly less blood loss compared to open surgery.
- Surgical outcomes were comparable between infants (<1 year) and older children (3-5 years) undergoing laparoscopic CC surgery.
- Outcomes for semi-emergency (EM) laparoscopic CC surgery were similar to elective (EL) procedures.
Conclusions:
- Laparoscopic definitive surgery for choledochal cysts is a safe and feasible option for infants under one year of age.
- Semi-emergency laparoscopic surgery can be performed safely and effectively in small infants with choledochal cysts.
- The findings support the use of minimally invasive techniques for choledochal cyst treatment across different pediatric age groups and urgency levels.
Background:
Laparoscopic definitive surgery for choledochal cyst (CC) in infants requires advanced skills because of their small size. If patients with a prenatal diagnosis of CC have any biliary symptoms, they need semi-emergency definitive surgery. This study aimed to estimate whether laparoscopic definitive surgery for CC can be performed safely and effectively in infants, especially when emergency surgery is required.
Patients And Methods:
From January 2006 to December 2019, 21 patients under 1 year of age underwent laparoscopically or open definitive surgery, and 16 patients aged 3-5 years underwent laparoscopic surgery for CC at our institution. In cases of prenatal diagnosis, elective surgery (EL) was performed at about 6 months of age for patients with no biliary symptoms; the semi-emergency surgery (EM) was performed when patients had any biliary symptoms. Surgical outcomes were retrospectively compared between the Lap <1 y and Op <1 y groups and between the Lap <1 y and Lap 3-5 y groups. In addition, the surgical outcomes of those who underwent EM were also evaluated.
Results:
Operative time was significantly longer, and blood loss was significantly lower in the Lap <1 y group than in the Op <1 y group. All surgical outcomes were similar between the Lap <1 y and Lap 3-5 y groups and between the EM and EL groups.
Conclusion:
Laparoscopic definitive surgery for CC in infants under 1 year of age is safe and feasible. Even semi-emergency laparoscopic surgery can be performed safely and effectively in small infants.
