A Twenty-year Experience in Choledochal Cysts in Children: From Open to Laparoscopic Excision

摘要

Choledochal cyst is a rare but potentially serious disease with a wide spectrum of presentation. The definitive treatment is an ultra-major operation aiming at complete cyst excision and reconstruction with a hepatico-jejunostomy. In current years, we have applied the laparoscopic technique in this condition. A retrospective review was carried out on our experience in the past 20 years. In the series, there were 75 patients, with laparoscopic surgery attempted in 39 and successfully performed in 36. Of the 75 patients, postoperative complications included intra-abdominal collections (8), bile leak (5), and postoperative small bowel intussusception (1). At a median follow-up of 7.5 years, 10 patients had encountered problems including adhesive small bowel obstruction (4), cholangitis (3), pancreatitis (1), requirement for liver transplant (1) and one mortality due to an unrelated problem. In conclusion, with appropriate management, a good outcome can usually be achieved but long-term follow-up is required for possible late problems.