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Curative effect and technical key points of laparoscopic surgery for choledochal cysts in children
Zedong Bian1,2, Yong Zhi1,2, Xinhao Zeng1,2
1Department of Pediatric Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Insights
Laparoscopic surgery for pediatric congenital choledochal cysts is safe and effective. This minimally invasive approach offers low trauma, minimal bleeding, and rapid recovery, leading to excellent outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Congenital choledochal cysts (CCCs) are rare biliary tract malformations requiring surgical intervention.
- Laparoscopic approaches are increasingly adopted for pediatric surgical conditions.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic surgery for treating congenital choledochal cysts in children.
- To assess the surgical experience and patient outcomes associated with this minimally invasive technique.
Main Methods:
- Retrospective analysis of 33 pediatric patients with congenital choledochal cysts (Types I and IV) undergoing laparoscopic resection and hepaticojejunostomy.
- Procedures performed between January 2019 and December 2021.
Main Results:
- Successful laparoscopic surgery without transit opening in all 33 cases.
- Mean operative time of 316 minutes, with minimal blood loss (mean 23 ml).
- Low complication rate (2 cases each of biliary fistula and pancreatitis), successfully managed conservatively; no major complications observed during a median follow-up of 17.2 months.
Conclusions:
- Laparoscopic surgery is a safe and effective treatment for pediatric congenital choledochal cysts.
- The minimally invasive nature results in reduced trauma, bleeding, and faster recovery.
- Satisfactory aesthetic results and long-term clinical improvement were observed.
Objective:
The purpose of this study was to investigate the curative effect of and experience with laparoscopic surgery for congenital choledochal cysts in children.
Methods:
This is a retrospective analysis of 33 children diagnosed with congenital choledochal cyst in the pediatric surgery department of the Affiliated Hospital of Southwest Medical University between January 2019 and December 2021. The cohort included 8 males and 25 females aged 0.25-13.7 years (median age, 3.2 years), including 21 cases of type I and 12 cases of type IV choledochal cyst (Todani classification). Laparoscopic choledochal cyst resection and hepaticojejunostomy with Roux-en-Y anastomosis were performed in all the patients.
Results:
Laparoscopy without transit opening was successfully performed in the 33 cases. The duration of the procedure was 235-460 min (mean ± SD, 316 ± 61 min), and intraoperative blood loss volume was 15-40 ml (23 ± 7.6 ml). Postoperative hospital stay was 7-14 days (9 ± 1.8 days). Postoperative biliary fistula and pancreatitis occurred in two cases each, and all four patients were successfully treated with conservative treatment. No anastomotic stenosis, delayed bleeding, cholangitis, intestinal obstruction, or other complications occurred. All the children were followed up for 2-36 months (median period, 17.2 months). The clinical symptoms disappeared, and no obvious hepatic dysfunction was found on abdominal color ultrasound and liver function examination.
Conclusion:
Laparoscopic surgery for congenital choledochal cyst in children is safe and effective, as it is a minimally invasive surgery that is associated with a low degree of trauma and bleeding, rapid postoperative recovery, and satisfactory aesthetic appearance.
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