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Erschienen in: Surgery Today 1/2018

29.05.2017 | Original Article

Laparoscopic surgery for congenital biliary dilatation: a single-institution experience

verfasst von: Mohammed Y. F. Aly, Yasuhisa Mori, Yoshihiro Miyasaka, Takao Ohtsuka, Yoshihiko Sadakari, Kohei Nakata, Yoshinao Oda, Shuji Shimizu, Masafumi Nakamura

Erschienen in: Surgery Today | Ausgabe 1/2018

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Abstract

Purpose

Laparoscopic surgery as a treatment for congenital biliary dilatation is uncommon. We herein present a series of laparoscopic surgeries for congenital biliary dilatation performed in our institution and review our experience with this approach over a long period of time.

Methods

Medical records of 36 consecutive patients who underwent laparoscopic surgery for congenital biliary dilatation from 1996 to 2015 were retrospectively reviewed. Data on patient demographics, operative time, blood loss, hospital stay, and complications were evaluated. A comparison between the former period (Group A, 1996–2005) and the latter period (Group B, 2006–2015) was performed.

Results

The patients comprised 23 females and 13 males with a median age of 34 years. The median operative time, blood loss, and hospital stay was 493 min, 154 g, and 11 days, respectively. Total early and late complications occurred in 7 (19%) and 2 (5%) patients, respectively. A comparison between Groups A and B revealed no significant difference in operative time or complications, but operative blood loss, open conversion, and hospital stay were significantly lower in Group B than in Group A (P < 0.05).

Conclusion

Laparoscopic surgery for congenital biliary dilatation is feasible and provides acceptable results. Further prospective studies of larger numbers of patients are needed.
Literatur
1.
Zurück zum Zitat Lipsett PA, Pitt HA. Surgical treatment of choledochal cysts. J Hepatobiliary Pancreat Surg. 2003;10:352–9.CrossRefPubMed Lipsett PA, Pitt HA. Surgical treatment of choledochal cysts. J Hepatobiliary Pancreat Surg. 2003;10:352–9.CrossRefPubMed
2.
Zurück zum Zitat Mizuguchi Y, Nakamura Y, Uchida E. Subsequent biliary cancer originating from remnant intrapancreatic bile ducts after cyst excision: a literature review. Surg Today. 2017;47:660–7.CrossRefPubMed Mizuguchi Y, Nakamura Y, Uchida E. Subsequent biliary cancer originating from remnant intrapancreatic bile ducts after cyst excision: a literature review. Surg Today. 2017;47:660–7.CrossRefPubMed
4.
Zurück zum Zitat Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledochal cysts in adults. Arch Surg. 2002;137:465–8.CrossRefPubMed Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledochal cysts in adults. Arch Surg. 2002;137:465–8.CrossRefPubMed
5.
Zurück zum Zitat Alonso-Lej F, Rever WB Jr, Pessagno DJ. Congenital choledochal cyst, with a report of 2, and an analysis of 94, cases. Int Abstr Surg. 1959;108:1–30.PubMed Alonso-Lej F, Rever WB Jr, Pessagno DJ. Congenital choledochal cyst, with a report of 2, and an analysis of 94, cases. Int Abstr Surg. 1959;108:1–30.PubMed
6.
Zurück zum Zitat Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134:263–9.CrossRefPubMed Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134:263–9.CrossRefPubMed
7.
Zurück zum Zitat de Vries JS, de Vries S, Aronson DC, Bosman DK, Rauws EA, Bosma A, et al. Choledochal cysts: age of presentation, symptoms, and late complications related to Todani’s classification. J Pediatr Surg. 2002;37:1568–73.CrossRefPubMed de Vries JS, de Vries S, Aronson DC, Bosman DK, Rauws EA, Bosma A, et al. Choledochal cysts: age of presentation, symptoms, and late complications related to Todani’s classification. J Pediatr Surg. 2002;37:1568–73.CrossRefPubMed
8.
Zurück zum Zitat Farello GA, Cerofolini A, Rebonato M, Bergamaschi G, Ferrari C, Chiappetta A. Congenital choledochal cyst: video-guided laparoscopic treatment. Surg Laparosc Endosc. 1995;5:354–8.PubMed Farello GA, Cerofolini A, Rebonato M, Bergamaschi G, Ferrari C, Chiappetta A. Congenital choledochal cyst: video-guided laparoscopic treatment. Surg Laparosc Endosc. 1995;5:354–8.PubMed
9.
Zurück zum Zitat Shimura H, Tanaka M, Shimizu S, Mizumoto K. Laparoscopic treatment of congenital choledochal cyst. Surg Endosc. 1998;12:1268–71.CrossRefPubMed Shimura H, Tanaka M, Shimizu S, Mizumoto K. Laparoscopic treatment of congenital choledochal cyst. Surg Endosc. 1998;12:1268–71.CrossRefPubMed
10.
Zurück zum Zitat Tanaka M, Shimizu S, Mizumoto K, Yokohata K, Chijiwa K, Yamaguchi K, et al. Laparoscopically assisted resection of choledochal cyst and Roux-en-Y reconstruction. Surg Endosc. 2001;15:545–52.CrossRefPubMed Tanaka M, Shimizu S, Mizumoto K, Yokohata K, Chijiwa K, Yamaguchi K, et al. Laparoscopically assisted resection of choledochal cyst and Roux-en-Y reconstruction. Surg Endosc. 2001;15:545–52.CrossRefPubMed
11.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien–Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien–Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed
13.
Zurück zum Zitat Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KK, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study. J Pediatr Surg. 2011;46:662–5.CrossRefPubMed Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KK, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study. J Pediatr Surg. 2011;46:662–5.CrossRefPubMed
14.
Zurück zum Zitat Senthilnathan P, Patel ND, Nair AS, Nalankilli VP, Vijay A, Palanivelu C. Laparoscopic management of choledochal cyst-technical modifications and outcome analysis. World J Surg. 2015;39:2550–6.CrossRefPubMed Senthilnathan P, Patel ND, Nair AS, Nalankilli VP, Vijay A, Palanivelu C. Laparoscopic management of choledochal cyst-technical modifications and outcome analysis. World J Surg. 2015;39:2550–6.CrossRefPubMed
15.
Zurück zum Zitat Chokshi NK, Guner YS, Aranda A, Shin CE, Ford HR, Nguyen NX. Laparoscopic choledochal cyst excision: lessons learned in our experience. J Laparoendosc Adv Surg Tech A. 2009;19:87–91.CrossRefPubMed Chokshi NK, Guner YS, Aranda A, Shin CE, Ford HR, Nguyen NX. Laparoscopic choledochal cyst excision: lessons learned in our experience. J Laparoendosc Adv Surg Tech A. 2009;19:87–91.CrossRefPubMed
16.
Zurück zum Zitat Liem NT, Pham HD, le Dung A, Son TN, Vu HM. Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients. J Laparoendosc Adv Surg Tech A. 2012;22:599–603.CrossRefPubMed Liem NT, Pham HD, le Dung A, Son TN, Vu HM. Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients. J Laparoendosc Adv Surg Tech A. 2012;22:599–603.CrossRefPubMed
17.
Zurück zum Zitat Yeung F, Chung PH, Wong KK, Tam PK. Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience. Pediatr Surg Int. 2015;31:149–53.CrossRefPubMed Yeung F, Chung PH, Wong KK, Tam PK. Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience. Pediatr Surg Int. 2015;31:149–53.CrossRefPubMed
18.
Zurück zum Zitat Li L, Feng W, Jing-Bo F, Qi-Zhi Y, Gang L, Liu-Ming H, et al. Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg. 2004;39:1663–6.CrossRefPubMed Li L, Feng W, Jing-Bo F, Qi-Zhi Y, Gang L, Liu-Ming H, et al. Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg. 2004;39:1663–6.CrossRefPubMed
19.
Zurück zum Zitat Hong L, Wu Y, Yan Z, Xu M, Chu J, Chen QM. Laparoscopic surgery for choledochal cyst in children: a case review of 31 patients. Eur J Pediatr Surg. 2008;18:67–71.CrossRefPubMed Hong L, Wu Y, Yan Z, Xu M, Chu J, Chen QM. Laparoscopic surgery for choledochal cyst in children: a case review of 31 patients. Eur J Pediatr Surg. 2008;18:67–71.CrossRefPubMed
20.
Zurück zum Zitat Lee KH, Tam YH, Yeung CK, Chan KW, Sihoe JD, Cheung ST, et al. Laparoscopic excision of choledochal cysts in children: an intermediate-term report. Pediatr Surg Int. 2009;25:355–60.CrossRefPubMed Lee KH, Tam YH, Yeung CK, Chan KW, Sihoe JD, Cheung ST, et al. Laparoscopic excision of choledochal cysts in children: an intermediate-term report. Pediatr Surg Int. 2009;25:355–60.CrossRefPubMed
21.
Zurück zum Zitat Liem NT, le Dung A, Son TN. Laparoscopic complete cyst excision and hepaticoduodenostomy for choledochal cyst: early results in 74 cases. J Laparoendosc Adv Surg Tech A. 2009;19:87–90.CrossRef Liem NT, le Dung A, Son TN. Laparoscopic complete cyst excision and hepaticoduodenostomy for choledochal cyst: early results in 74 cases. J Laparoendosc Adv Surg Tech A. 2009;19:87–90.CrossRef
22.
Zurück zum Zitat Diao M, Li L, Cheng W. Laparoscopic versus Open Roux-en-Y hepatojejunostomy for children with choledochal cysts: intermediate-term follow-up results. Surg Endosc. 2011;25:1567–73.CrossRefPubMed Diao M, Li L, Cheng W. Laparoscopic versus Open Roux-en-Y hepatojejunostomy for children with choledochal cysts: intermediate-term follow-up results. Surg Endosc. 2011;25:1567–73.CrossRefPubMed
23.
Zurück zum Zitat Jang JY, Yoon YS, Kang MJ, Kwon W, Park JW, Chang YR, et al. Laparoscopic excision of a choledochal cyst in 82 consecutive patients. Surg Endosc. 2013;27:1648–52.CrossRefPubMed Jang JY, Yoon YS, Kang MJ, Kwon W, Park JW, Chang YR, et al. Laparoscopic excision of a choledochal cyst in 82 consecutive patients. Surg Endosc. 2013;27:1648–52.CrossRefPubMed
24.
Zurück zum Zitat Hwang DW, Lee JH, Lee SY, Song DK, Hwang JW, Park KM, et al. Early experience of laparoscopic complete en bloc excision for choledochal cysts in adults. Surg Endosc. 2012;26:3324–9.CrossRefPubMed Hwang DW, Lee JH, Lee SY, Song DK, Hwang JW, Park KM, et al. Early experience of laparoscopic complete en bloc excision for choledochal cysts in adults. Surg Endosc. 2012;26:3324–9.CrossRefPubMed
25.
Zurück zum Zitat Lal R, Agarwal S, Shivhare R, Kumar A, Sikora SS, Saxena R, et al. Type IV-A choledochal cysts: a challenge. J Hepatobiliary Pancreat Surg. 2005;12:129–34.CrossRefPubMed Lal R, Agarwal S, Shivhare R, Kumar A, Sikora SS, Saxena R, et al. Type IV-A choledochal cysts: a challenge. J Hepatobiliary Pancreat Surg. 2005;12:129–34.CrossRefPubMed
26.
Zurück zum Zitat Li S, Wang W, Yu Z, Xu W. Laparoscopically assisted extrahepatic bile duct excision with ductoplasty and a widened hepaticojejunostomy for complicated hepatobiliary dilatation. Pediatr Surg Int. 2014;30:593–8.CrossRefPubMed Li S, Wang W, Yu Z, Xu W. Laparoscopically assisted extrahepatic bile duct excision with ductoplasty and a widened hepaticojejunostomy for complicated hepatobiliary dilatation. Pediatr Surg Int. 2014;30:593–8.CrossRefPubMed
27.
Zurück zum Zitat Jung K, Han HS, Cho JY, Yoon YS, Hwang DW. Is preoperative subclassification of type I choledochal cyst necessary? Korean J Radiol. 2012;13:112–6.CrossRef Jung K, Han HS, Cho JY, Yoon YS, Hwang DW. Is preoperative subclassification of type I choledochal cyst necessary? Korean J Radiol. 2012;13:112–6.CrossRef
28.
Zurück zum Zitat Urushihara N, Fukuzawa H, Fukumoto K, Sugiyama A, Nagae H, Watanabe K, et al. Totally laparoscopic management of choledochal cyst: Roux-en-Y Jejunojejunostomy and wide hepaticojejunostomy with hilar ductoplasty. J Laparoendosc Adv Surg Tech A. 2011;21:361–6.CrossRefPubMed Urushihara N, Fukuzawa H, Fukumoto K, Sugiyama A, Nagae H, Watanabe K, et al. Totally laparoscopic management of choledochal cyst: Roux-en-Y Jejunojejunostomy and wide hepaticojejunostomy with hilar ductoplasty. J Laparoendosc Adv Surg Tech A. 2011;21:361–6.CrossRefPubMed
29.
Zurück zum Zitat Stringer MD. Wide hilar hepaticojejunostomy: the optimum method of reconstruction after choledochal cyst excision. Pediatr Surg Int. 2007;23:529–32.CrossRefPubMed Stringer MD. Wide hilar hepaticojejunostomy: the optimum method of reconstruction after choledochal cyst excision. Pediatr Surg Int. 2007;23:529–32.CrossRefPubMed
30.
Zurück zum Zitat Morotomi Y, Todani T, Watanabe Y, Noda T, Otsuka K. Modified Kasai’s procedure for a choledochal cyst with a very narrow hilar duct. Pediatr Surg Int. 1996;11:58–9.CrossRefPubMed Morotomi Y, Todani T, Watanabe Y, Noda T, Otsuka K. Modified Kasai’s procedure for a choledochal cyst with a very narrow hilar duct. Pediatr Surg Int. 1996;11:58–9.CrossRefPubMed
31.
Zurück zum Zitat Kim JH, Choi TY, Han JH, Yoo BM, Kim JH, Hong J, et al. Risk factors of postoperative anastomotic stricture after excision of choledochal cysts with hepaticojejunostomy. J Gastrointest Surg. 2008;12:822–8.CrossRefPubMed Kim JH, Choi TY, Han JH, Yoo BM, Kim JH, Hong J, et al. Risk factors of postoperative anastomotic stricture after excision of choledochal cysts with hepaticojejunostomy. J Gastrointest Surg. 2008;12:822–8.CrossRefPubMed
Metadaten
Titel
Laparoscopic surgery for congenital biliary dilatation: a single-institution experience
verfasst von
Mohammed Y. F. Aly
Yasuhisa Mori
Yoshihiro Miyasaka
Takao Ohtsuka
Yoshihiko Sadakari
Kohei Nakata
Yoshinao Oda
Shuji Shimizu
Masafumi Nakamura
Publikationsdatum
29.05.2017
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 1/2018
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-017-1545-3

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