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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

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Does Bile Exposure During Surgery Affect the Postoperative Recovery and Complications of Pediatric Patients With

Keisuke Yano1, Masakazu Murakami1, Shun Onishi1

  • 1Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.

Asian Journal of Endoscopic Surgery
|October 21, 2025
PubMed

Insights

Bile exposure during laparoscopic surgery for pediatric choledochal cysts did not impact overall recovery but increased the risk of postoperative cholangitis. Further research is needed to understand this association.

Area of Science:

  • Pediatric Surgery
  • Hepatobiliary Surgery
  • Gastroenterology

Background:

  • Bile exposure (BE) in hepatobiliary surgery can lead to complications like bile peritonitis and delayed recovery in adults.
  • The impact of BE on pediatric patients undergoing laparoscopic treatment for choledochal cysts (CCs) remains unclear.

Purpose of the Study:

  • To investigate the effect of intraoperative bile exposure on postoperative recovery and complications in pediatric patients with choledochal cysts undergoing laparoscopic surgery.

Main Methods:

  • Retrospective review of medical records for pediatric patients with CCs treated laparoscopically between April 2016 and April 2024.
  • Patients were categorized into two groups: those with bile exposure (BE group) and those without (control group).
  • Comparison of patient characteristics, operative outcomes, and postoperative complications between the two groups.

Main Results:

  • Forty-three patients were analyzed (25 control, 18 BE group) with no significant differences in baseline characteristics or operative results.
  • The incidence of postoperative cholangitis was significantly higher in the BE group (33.3%) compared to the control group (4.0%) (p=0.003).
  • No significant differences were observed in the rates of anastomotic stenosis or intrahepatic stones between the groups.

Conclusions:

  • Intraoperative bile exposure did not adversely affect overall postoperative recovery in pediatric patients with CCs undergoing laparoscopic surgery.
  • Bile exposure was associated with a significantly higher incidence of postoperative cholangitis.
  • Further research is warranted to elucidate the mechanisms linking bile exposure to postoperative cholangitis in this patient population.
Abstract

Keywords:
bile exposurecholedochal cystcomplicationslaparoscopic surgerypostoperative recovery

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