Laparoscopic Versus Open Surgery in Children with Choledochal Cysts

Authors

  • Patchareeporn Tanming Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen Province.
  • Kanokrat Thaiwatcharamas
  • Ratiyaporn Phannua

Keywords:

choledochal cyst; Laparoscopic surgery in children; Early experience

Abstract

Background and Objective: Choledochal cyst is an abnormal cystic dilatation of the biliary system. Many literature showed the laparoscopic surgery is a safe procedure when compared with open approach. The objective of this study was to compare the clinical safety of laparoscopic surgery with conventional open surgery in our hospital.

Methods: A retrospective study was conducted on all patients younger than 18 years who presented with a choledochal cyst in Srinagarind hospital from January 2014 to November 2019. The data were collected from medical records. The clinical safety defined as the operative time, intraoperative blood transfusion, blood loss, postoperative complication, time of first food intake and length of hospital stay. Data were compared between the 2 groups.

Results: A total of 29 patients were reviewed. 25 patients underwent open surgery, whereas 4 patients underwent laparoscopic reconstruction. Operative time and the cystic size had significant difference. The operative time in Laparoscopic group was 663.8 ±67.5 minutes and open group was 326.4 ± 138.5 minutes (p < 0.001). The cyst size in laparoscopic group was 1.5 cm. and in open surgery group was 4.5 cm. (p = 0.005).  There were no significant difference among other factors of  both groups.

Conclusions: Our initial experience indicates that the laparoscopic approach is safe and having no difference in the patient outcomes, including the complications when compared with the open operation.

References

1. Pediatric surgery. 7th. Coran. Elsevier Mosby; 2012.
2. Park SW, Koh H, Oh JT, Han SJ, Kim S. Relationship between anomalous pancreaticobiliary ductal union and pathologic inflammation of bile duct in choledochal cyst. Pediatr Gastroenterol Hepatol Nutr [Internet]. 2014; 17: 170–7. [cited Dec 3, 2019]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25349833
3. Yamataka A, Kato Y, Miyano T. Ashcraft’s Pediatric Surgery. 5th edition. Philadelphia: Elsevier ; 2010: 557–77.
4. Huang CS, Huang CC, Chen DF. Choledochal cysts: Differences between pediatric and adult patients. J Gastrointest Surg 2010; 14: 1105–10.
5. Shen HJ, Xu M, Zhu HY, Yang C, Li F, Li K wei, et al. Laparoscopic versus open surgery in children with choledochal cysts: a meta-analysis. Pediatr Surg Int 2015; 31: 529–34.
6. Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KKY, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: A midterm follow-up study. J Pediatr Surg [Internet]. 2011; 46: 662–5. [cited Dec 3,2019]. Available from: http://dx.doi.org/10.1016/j.jpedsurg.2010.10.012
7. Liuming H, Hongwu Z, Gang L, Jun J, Wenying H, Wong KKY, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: A midterm follow-up study. J Pediatr Surg [Internet]. 2011; 46: 662–5. [cited Dec 3, 2019] Available from: http://dx.doi.org/10.1016/j.jpedsurg.2010.10.012
8. Liem NT, Pham HD, Dung LA, Son TN, Vu HM. Early and intermediate outcomes of laparoscopic surgery for choledochal cysts with 400 patients. J Laparoendosc Adv Surg Tech [Internet]. 2012; 22: 599–603. [cited Dec 3, 2019]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22691183
9. She WH, Chung HY, Lan LCL, Wong KKY, Saing H, Tam PKH. Management of choledochal cyst: 30 years of experience and results in a single center. J Pediatr Surg [Internet]. 2009; 44: 2307–11. [cited Dec 3,2019]. Available from: https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0022346809006265?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0022346809006265%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.ncbi.nlm.nih.gov%2F
10. Aspelund G, Ling SC, Ng V, Kim PCW. A role for laparoscopic approach in the treatment of biliary atresia and choledochal cysts. [cited Dec 16, 2019]; Available from: www.elsevier.com/locate/jpedsurg

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Published

2020-04-08

How to Cite

1.
Tanming P, Thaiwatcharamas K, Phannua R. Laparoscopic Versus Open Surgery in Children with Choledochal Cysts . SRIMEDJ [Internet]. 2020 Apr. 8 [cited 2024 Dec. 24];35(2):119-24. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/241453

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Original Articles