Laparoscopic single stage procedure for perforated choledochal cyst

Abstract

Spontaneous perforation of choledochal cyst is a rare presentation. Complicated choledochal cysts are routinely managed by staged open surgical procedures for excision and reconstruction [1, 2]. Complex laparoscopic surgery in infants is an evolving field but no reports have been published describing a minimal invasive approach to the management of spontaneous perforation of choledochal cyst. We report a case of perforated choledochal cyst in a 12 week old, female which was managed by single stage laparoscopic resection of the cyst with biliary reconstruction. She presented with fever and bilious vomiting for 4 days. She had chemical pancreatitis and further work up showed her to have a perforated choledochal cyst. After conservative treatment of her pancreatitis, she underwent laparoscopic resection of the choledochal cyst with reconstruction. She had an uneventful postoperative recovery. This is the first ever reported case of laparoscopic management of a perforated choledochal cyst in infants which was managed by single stage laparoscopic surgery with immediate reconstruction.