Single-incision Versus Conventional Laparoscopic Cyst Excision and Roux-Y Hepaticojejunostomy for Children with Choledochal Cysts: a Case-control Study

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2013 Mar 30

PMID 23539195

Citations 11

Authors

Mei Diao

Long Li

Qi Li

Mao Ye

Wei Cheng

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to compare the efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) with that of conventional laparoscopic hepaticojejunostomy (CLH) for children with choledochal cysts (CDCs).

Methods: Patients undergoing SILH between April 2011 and April 2012 were matched with those undergoing CLH between January 2009 and April 2011 for age, sex, CDC types, size, and operative surgeon. The operating time, postoperative hospital stay, time to full feed, postoperative complications, and perioperative laboratory tests were compared.

Results: A total of 150 patients (SILH 75, CLH 75) were evaluated. Median follow-up periods of SILH and CLH groups were 12 and 34 months, respectively. The postoperative hospital stay and time required for resumption of full diet were similar for the two groups (p = 0.93 and 0.16, respectively). Early in the series, one (1.3 %) SILH patient developed bile leak. It was successfully managed with 10 days of drainage. No mortality or morbidities-anastomotic stenosis, cholangitis, pancreatic leak, intestinal obstruction, intrahepatic reflux-were encountered. Overall complication rates were identical in the two groups (p = 0.32).

Conclusions: SILH is safe in the hands of experienced laparoscopic hepaticobiliary surgeons. It achieves comparable outcomes with less surgical scar.

Citing Articles

Single-incision laparoscopic hepaticojejunostomy with selective ductoplasty for type IV-A Choledochal cysts in children: a retrospective study.

Liu W, Yin T, Chen X, Diao M, Li L BMC Surg. 2024; 24(1):359.

PMID: 39548424 PMC: 11566446. DOI: 10.1186/s12893-024-02648-0.

Comparison of Deep and Moderate Neuromuscular Blockade for Major Laparoscopic Surgery in Children: A Randomized Controlled Trial.

Wei G, Li Y, Chen Y, Diao M, Zhong J, Pan S Paediatr Drugs. 2024; 26(3):347-353.

PMID: 38512578 DOI: 10.1007/s40272-024-00622-0.

Modified single-port versus multiport laparoscopic choledochal cysts excision and Roux-en-Y hepaticojejunostomy: a retrospective comparative cohort study.

Wang Z, Guan X, Yu J, Zhong W Transl Pediatr. 2022; 11(11):1831-1839.

PMID: 36506772 PMC: 9732595. DOI: 10.21037/tp-22-557.

A narrative review of the modern surgical management of pediatric choledochal cysts.

Jones R, Zagory J, Clark R, Pandya S Transl Gastroenterol Hepatol. 2021; 6:37.

PMID: 34423158 PMC: 8343510. DOI: 10.21037/tgh-20-235.

Laparoscopic management of choledochal cyst in children: Lessons learnt from low-middle income countries.

Liem N, Agrawal V, Aison D J Minim Access Surg. 2020; 17(3):279-286.

PMID: 32964871 PMC: 8270031. DOI: 10.4103/jmas.JMAS_114_20.

References

Gill R, Shi X, Al-Adra D, Birch D, Karmali S . Single-incision appendectomy is comparable to conventional laparoscopic appendectomy: a systematic review and pooled analysis. Surg Laparosc Endosc Percutan Tech. 2012; 22(4):319-27. DOI: 10.1097/SLE.0b013e31824f2cf8. View

Li L, Feng W, Jing-Bo F, Qi-Zhi Y, Gang L, Liu-Ming H . Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg. 2004; 39(11):1663-6. DOI: 10.1016/j.jpedsurg.2004.07.012. View

Diao M, Li L, Cheng W . Is it necessary to ligate distal common bile duct stumps after excising choledochal cysts?. Pediatr Surg Int. 2011; 27(8):829-32. DOI: 10.1007/s00383-011-2877-5. View

Diao M, Li L, Cheng W . To drain or not to drain in Roux-en-Y hepatojejunostomy for children with choledochal cysts in the laparoscopic era: a prospective randomized study. J Pediatr Surg. 2012; 47(8):1485-9. DOI: 10.1016/j.jpedsurg.2011.10.066. View

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. 2010; 25(5):1567-73. DOI: 10.1007/s00464-010-1435-x. View

Tam Y, Lee K, Sihoe J, Chan K, Cheung S, Pang K . Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery. J Pediatr Surg. 2010; 45(12):2381-5. DOI: 10.1016/j.jpedsurg.2010.08.036. View

Diao M, Li L, Dong N, Li Q, Cheng W . Single-incision laparoscopic Roux-en-Y hepaticojejunostomy using conventional instruments for children with choledochal cysts. Surg Endosc. 2011; 26(6):1784-90. DOI: 10.1007/s00464-011-2110-6. View

Chow A, Purkayastha S, Paraskeva P . Appendicectomy and cholecystectomy using single-incision laparoscopic surgery (SILS): the first UK experience. Surg Innov. 2009; 16(3):211-7. DOI: 10.1177/1553350609344413. View

Blanco F, Kane T . Single-port laparoscopic surgery in children: concept and controversies of the new technique. Minim Invasive Surg. 2012; 2012:232347. PMC: 3384965. DOI: 10.1155/2012/232347. View

10.

Hansen E, Muensterer O, Georgeson K, Harmon C . Single-incision pediatric endosurgery: lessons learned from our first 224 laparoendoscopic single-site procedures in children. Pediatr Surg Int. 2010; 27(6):643-8. DOI: 10.1007/s00383-010-2735-x. View

11.

Pisanu A, Reccia I, Porceddu G, Uccheddu A . Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC). J Gastrointest Surg. 2012; 16(9):1790-801. DOI: 10.1007/s11605-012-1956-9. View

12.

Diao M, Li L, Zhang J, Cheng W . A shorter loop in Roux-Y hepatojejunostomy reconstruction for choledochal cysts is equally effective: preliminary results of a prospective randomized study. J Pediatr Surg. 2010; 45(4):845-7. DOI: 10.1016/j.jpedsurg.2009.12.022. View

13.

Rothenberg S, Shipman K, Yoder S . Experience with modified single-port laparoscopic procedures in children. J Laparoendosc Adv Surg Tech A. 2009; 19(5):695-8. DOI: 10.1089/lap.2009.0148. View