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. 2022 Jul-Sep;18(3):372-377.
doi: 10.4103/jmas.JMAS_98_21.

Laparoscopic definitive surgery for choledochal cyst is performed safely and effectively in infants

Takahisa Tainaka  1 , Chiyoe Shirota  1 , Wataru Sumida  1 , Kazuki Yokota  1 , Satoshi Makita  1 , Hizuru Amano  1 , Masamune Okamoto  1 , Aitaro Takimoto  1 , Yoko Kano  1 , Akihiro Yasui  1 , Yoichi Nakagawa  1 , Akinari Hinoki  1 , Hiroo Uchida  1
Affiliations

Laparoscopic definitive surgery for choledochal cyst is performed safely and effectively in infants

Takahisa Tainaka et al. J Minim Access Surg. 2022 Jul-Sep.

Abstract

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.

Keywords: Choledochal cyst; infants; laparoscopic surgery.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) Septal stenosis (arrowhead) is observed. (b) The septum has been incised (case of a 3-month-old girl)
Figure 2
Figure 2
(a) Membranous stenosis (arrowhead) is observed in the right intrahepatic bile duct. (b) Another membranous stenosis is observed. (c) The lumen of the bile duct has been expanded after intrahepatic bile ductoplasty (case of a 1-month-old girl)
See this image and copyright information in PMC

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