Laparoscopic Versus Open Surgery in Children with Choledochal Cysts

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Patchareeporn Tanming
Kanokrat Thaiwatcharamas
Ratiyaporn Phannua

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.

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