Feasibility of laparoscopic choledochal cyst excision after external drainage

Abstract

Objective To evaluate the feasibility of second-stage laparoscopic choledochal cyst excision with hepaticojejunostomy after external drainage. Methods From October 2014 to October 2016, 6 hospitalized cases with choledochal cyst after cyst external drainage were recruited. Second-stage laparoscopic cyst excision plus biliary reconstruction was performed. And clinical data and surgical techniques were analyzed. Results All liver function tests were normal. Contrast studies of biliary tract were routinely performed. Conventional 4-port laparoscopic technique was employed. Due to severe intra-abdominal adhesion around drain tube, dissection was lengthy. Choledochal cysts were completely resected and hepaticojejunostomy was constructed in all patients. Ductoplasty was performed in one patient whose drain tube was located near the confluence of left and right hepatic ducts. Abdominal drain was implanted routinely. The operative duration was between 3.5 to 5.0 hours. The volume of bleeding had a range of 5 to 10 ml. Patient recovery was uneventful. And postoperative hospital stay lasted 6 to 8 days. During a follow-up period of 2-24 months, there was no occurrence of abdominal pain or other complications. Conclusions Laparoscopic choledochal cyst excision after external drainage is feasible with encouraging outcomes. Key words: Choledochal cyst; Laparoscopes; Drainage.