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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Robot-assisted radical resection for choledochal cysts in infants under three months of age: a multicenter
Lirong Zhang1, Peng Song1, Yunfeng Xiao1
1Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Insights
Robot-assisted radical resection is safe and effective for infants under three months old with congenital choledochal cysts. This minimally invasive approach led to successful surgeries without major complications and favorable long-term outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Robotics
Background:
- Congenital choledochal cysts are rare bile duct malformations.
- Infants under three months present unique surgical challenges.
- Obstructive jaundice is a primary clinical manifestation.
Purpose of the Study:
- To evaluate the clinical efficacy and surgical experience of robot-assisted radical resection.
- To assess the safety and feasibility of this approach in very young infants.
- To analyze outcomes in infants under three months with congenital choledochal cysts.
Main Methods:
- A multicenter retrospective study included 31 infants (<3 months old) with congenital choledochal cysts.
- All patients underwent robot-assisted radical resection.
- Data on operative time, complications, feeding, and follow-up were collected.
Main Results:
- Successful surgery was achieved in all 31 cases without conversion to open surgery.
- No major early complications (bile leakage, pancreatitis, obstruction) were observed.
- Follow-up showed resolution of symptoms and normal growth and development.
Conclusions:
- Robot-assisted radical resection is a safe and effective option for infants under three months with choledochal cysts.
- The procedure demonstrated favorable outcomes, including successful completion and absence of major complications.
- Further comparative studies are needed to compare with laparoscopic approaches.
Background:
To analyze the clinical efficacy and surgical experience of robot-assisted radical resection for choledochal cysts in infants under three months of age.
Methods:
This was a multicenter retrospective study conducted at the Department of Pediatric Surgery, Mianyang Central Hospital, and Chengdu Women's and Children's Central Hospital. A total of 31 patients diagnosed with congenital choledochal cysts under three months of age between May 2021 and May 2026 were included. The cohort comprised 9 boys and 22 girls, aged 10-86 days (median age: 52 days), with a body weight ranging from 3.0 to 6.5 kg (mean weight: 3.83 ± 0.75 kg). The primary clinical manifestation was obstructive jaundice. All patients underwent robot-assisted radical resection of choledochal cysts and were discharged after the resumption of feeding and the absence of postoperative complications.
Results:
Surgery was successfully completed in all 31 cases without conversion to open surgery. The operative time ranged from 173 to 239 min, with a median time of 190 min. All patients initiated feeding 24-48 h postoperatively, and No major early complications (e.g., bile leakage, pancreatitis, intestinal obstruction) occurred. Transient hyperbilirubinemia was observed in 12 patients (38.7%), which resolved with conservative management. The postoperative hospital stay ranged from 8 to 11 days, with a median stay of 9 days. All patients were followed up for 6-28 months. During the follow-up period, symptoms related to biliary obstruction resolved, and there were no occurrences of internal hernia, intestinal obstruction, or biliary stricture. All patients exhibited normal growth and development.
Conclusion:
For infants under three months of age with congenital choledochal cysts who present with surgical indications, robot-assisted radical resection appears safe and effective.This approach appears safe and feasible for carefully selected infants under three months of age. Favorable outcomes were observed, including successful completion of surgery without conversion, absence of major complications, and satisfactory cosmetic results. Further comparative studies are warranted to establish its role relative to laparoscopic surgery.