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Erschienen in:
25.01.2018 | Original Scientific Report
Cysto-cholecystostomy: A More Physiological Procedure for Hepatic Cysts with Biliary Communications and Cystic Dilatations of Main Intrahepatic Ducts
Erschienen in: World Journal of Surgery | Ausgabe 8/2018
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Objective
Hepatic cysts with biliary communications (HC) and cystic dilatations of main intrahepatic ducts (CIHD) can cause biliary obstruction, cholestasis, stone formation, cholangitis, liver damage and carcinoma. Conventionally, Roux-Y cysto-jejunostomy is employed to manage these conditions. However, it is technically demanding and may be complicated with major biliary disruption and bacteria migration from intestine to intrahepatic duct. We have carried out laparoscopic cysto-cholecystostomies for HC with biliary communication and CIHD and evaluated outcomes.
Methods
Twenty patients with HC (n = 10) or CIHD (n = 10) who successfully underwent laparoscopic cysto-cholecystostomies in our center, between September 2010 and March 2017, were reviewed.
Results
The mean age of the patients at surgery was 2.06 and 2.23 years for HC and CIHD groups, respectively. Eighteen patients were symptomatic, with abdominal pain, fever, vomiting and jaundice. Laboratory results showed abnormal liver functions in 8 patients. Pathological results verified hepatic cellular damages in 8 patients. The mean operative time was 0.97 and 0.92 h for HC and CIHD patients, respectively. The median follow-up duration was 27 months (1–54 months) and 35 months (1–79 months) for HC and CIHD groups, respectively. No patient developed bile leak, anastomotic stenosis, stone formation or cholangitis. Liver function normalized postoperatively.
Conclusions
Laparoscopic cysto-cholecystostomy is a simpler and more physiological surgical alternative for managing HC with biliary communication and CIHD.