Laparoscopic treatment of congenital choledochal cyst and hepaticojejunostomy with extracorporeal Roux-en-Y anastomosis: technical aspects and early experience with three cases.
نویسندگان
چکیده
Choledochal cyst (CDC) is a congenital dilatation of the extra and/or intrahepatic bile ducts and it is a rare condition in western countries. Classical treatment consists of cyst excision and hepaticojejunostomy. The first case of a laparoscopic CDC excision was described in 1995 and since that time an increasing number of institutions have adopted this technique, with good success. We describe our early experience of 3 cases of CDC treated with laparoscopic approach. We used a 10 mm umbilical port for the camera, and four 3-5 mm operative ports. We performed the laparoscopic removal of the cyst and gallbladder, videoassisted preparation of the Roux-en-Y loop and laparoscopic hepaticjejunostomy. No post-operative complications occurred. Laparoscopic excision of CDCs has been supposed to give better observation, a better cosmetic result, potentially less postoperative pain, and a shorter recovery. The main argument for performing an extracorporeal anastomosis is that it decreases the operative time. We recommend caution to prevent injury to the pancreatic duct and biliary structures during dissection and anastomosis. Lifelong surveillance is mandatory, even after resection of the choledochal cyst.
منابع مشابه
A case of robot-assisted excision of choledochal cyst, hepaticojejunostomy, and extracorporeal Roux-en-y anastomosis using the da Vinci surgical system.
Choledochal cyst is a rare disease in the Western world, but a high incidence is noted in Asia. Complete cyst excision with Roux-en-y hepaticoenterostomy is the treatment of choice for choledochal cyst, which has been attempted laparoscopically with the advancement of laparoscopic experience. Recently, a telemanipulative robotic surgical system was introduced, providing instruments with wrist-t...
متن کاملRobot-assisted complete excision of choledochal cyst type I, hepaticojejunostomy and extracorporeal Roux-en-y anastomosis: a case report and review literature
For Choledochal cyst type I, complete excision of cyst with Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a telemanipulative robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field...
متن کاملLaparoscopic total intracorporeal correction of choledochal cyst in pediatric population.
BACKGROUND The laparoscopic correction of the choledochal cyst is an attractive treatment option. However, even the skilled surgeons do not prefer the intracorporeal jejunojejunal anastomosis due to the technical difficulties. In this article, we present the feasibility of laparoscopic total intracorporeal correction of the choledochal cyst, including the retrocolic Roux-en-Y hepaticojejunostom...
متن کاملRobot-assisted Complete Excision of Choledochal Cyst with Hepaticojejunostomy and Roux-en-Y Anastomosis
متن کامل
Choledochal Cyst in an Adult: Congenital or an Acquired Clinical Entity?
Cystic dilation of biliary ducts, otherwise known as choledochal cyst, is an uncommon condition frequently present in infancy and childhood but increasingly diagnosed in adults. Until now, no unifying etiologic theory exists for choledochal cysts, but most literature would conclude they are congenital bile duct anomalies. This report discusses choledochal cyst in a 50-year-old female post-lapar...
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عنوان ژورنال:
- La Pediatria medica e chirurgica : Medical and surgical pediatrics
دوره 38 2 شماره
صفحات -
تاریخ انتشار 2016