Comparison of outcomes of laparoscopic choledochal cyst excision and roux-en-y hepaticojejunostomy between children and adults

Abstract

Introduction: The aim of this study is to compare the outcomes of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy between adults and children

Material and Methods: A prospective study of 19 adults and 51 children with choledochal cyst treated by laparoscopic surgery at Hue Central Hospital from 1/2012 to 12/2017.

Results: The average operative time was 219.79 ± 64.88 minutes. The average operative time in adults was longer than in children (233.42 vs 219.79 minutes). There was a statistically significant difference between two groups. Intraoperative blood transfusion was required in two patients in children group. The time from surgery to drainage removal was shorter in adults (2.89 vs 3.57 days). Postoperative follow-up results after 10 days to 3 months were classified as good and fair. There were no statistically significant differences in early postoperative complications, treatment outcomes between two groups.

Conclusion: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was safe and efficient in both adults and children. Operative time was longer in adults than in children.

Keyword: laparoscopy, choledochal cyst.

References: 

1. Huynh Co, Dao Trung Dien, Nguyen Tan Cuong, Truong Nguyen Uy, Le Tan Son, Huynh Cong Bang (2012), the Comparison of outcomes of laparoscopic choledochal cyst excision…  Nguyen Thanh Xuan et al. culture of video games in the General Games in our game, a in different things, 4 (816), p. 57-60.
2. Do Manh Hung, Do Tuan Anh, Nguyen Khac Duc, Tran Dinh Tho, Nguyen Quang Nghia, Trinh Quoc Dat, Tran Binh Giang (2014), Hoi phoenix in the worksheet in your screen Viet Duc University Hospital, Dark and dark, clear and dark, soi and Viet soi, Vietnam, 1 (4), p. 5-10.
3. Do Minh Hung (2013), from Nc 584, our device, one of the delicious, delicious, palatable food 304-310.
4. Do Minh Hung (2015), their culture and equipment.
5. Chu Van Lai, Truong Nguyen Uy Linh (2014), “The effectiveness of cystectomy in treating bile duct perforation in children”, Medical Journal of Ho Chi Minh City, 18 (1), p. 529-533.
6. Ho Huu Thien, Pham Nhu Hiep, Pham Anh Vu, Phan Hai Thanh, Nguyen Thanh Xuan, Van Tien Nhan, Tran Nghiem Trung (2009), “Endoscopic surgery to treat a common bile duct cyst in children: results first step at Hue Central Hospital ”, Journal of Practical Medicine, 690 + 691, p. 64-68.
7. Ta Van Tung, Le Tat Hai, Duong Van Hung (2013), “Evaluation of the results of treatment of 26 common bile duct cysts with laparoscopic surgery at Thanh Hoa Children’s Hospital”, Journal of Endoscopic Surgery and Endoscopy of Vietnam, 3 (3), p. 18-22.
8. Nguyen Thanh Xuan, Pham Nhu Hiep, Ho Huu Thien, Pham Anh Vu, Phan Hai Thanh, Le Dinh Khanh, Dao Le Minh Chau (2013), “Treatment of a common bile duct cyst with laparoscopic surgery”, Surgery Endoscopy and Vietnam Endoscopy, 1 (3): pp.22-25.
9. Acker SN, Bruny JL, Narkewicz MR, Roach JP, Rogers A, Karrer FM (2013), “Preoperative imaging does not predict intrahepatic involvement in choledochal cysts”, J Pediatr Surg, 48(12):2378-2382.
10. Dabbas N., Davenport M (2009), “Congenital choledochal malformation: not just a problem for children”. Ann R Coll Surg Engl, 91(2), pp.100-105.
11. Fujishiro J, Masumoto K, Urita Y, Shinkai T, Gotoh C (2013), “Pancreatic complications in pediatric choledochal cysts”, J Pediatr Surg, 48(9):1897-1902
12. Huang CS, Huang CC, Chen DF (2010), “Choledochal cysts: differences between pediatric and adult patients”, J Gastrointest Surg, 14(7):1105-1110.
13. Liem NT, Pham HD, Dung le A, Son TN, Vu HM (2012), “Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients”, J Laparoendosc Adv Surg Tech A, 22(6):599-603.
14. Liu Y, Yao X, Li S, Liu W, Liu L, Liu J (2014), “Comparison of Therapeutic Effects of Laparoscopic and Open Operation for Congenital Choledochal Cysts in Adults”, Gastroenterol Res Pract, 2014:670260.
15. Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KK, Miao X, Qizhi Y, Jun Z, Shuli L, Li L (2011), “The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study”, J Pediatr Surg, 46(4):662-665.
16. Ramadwar R, Salgaonkar H, Sawant (2011), “Laparoscopic Management of Choledochal cyst – Our experience of 49 cases”, Pediatr Surg Int, 28(5), pp.443-447.
17. Sheng Q, Lv Z, Xu W, Xiao X, Liu J, Wu Y (2017), “Reoperation After Cyst Excision with Hepaticojejunostomy for Choledochal Cysts: Our Experience in 18 Cases”, Med Sci Monit, 23:1371-1377.
18. Tang ST, Yang Y, Wang Y (2011), “Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases”, Surg Endosc, 25(2), pp.416-422.
19. Woon C.Y, Tan Y.M, Oei C.L, Chung A.Y, Chow P.K, Ooi L.L (2006), “Adult choledochal cysts: An audit of surgical management”, ANZ J Surg, 76 (11):pp.981-986.