Laparoscopic Surgery in the treatment of children with Choledochal Cyst.

Xiushui Qu,Lihua Cui,Junchao Xu

doi:10.12669/pjms.35.3.85

Xiushui Qu, Lihua Cui + Show 1 more

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https://doi.org/10.12669/pjms.35.3.85

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Abstract

Objective:To evaluate the clinical effectiveness of laparoscopic surgery in the treatment of children with choledochal cyst.Methods:Seventy-six children with congenital choledochal cyst who were admitted to our hospital between February 2016 and April 2017 were selected as research subjects. They were evenly divided into an observation group and a control group using random number table, 38 each group. Patients in the observation group underwent laparoscopic surgery, while patients in the control group underwent the traditional laparotomy. Surgery related indicators and prognosis were compared between the two groups.Results:The incision size and intraoperative bleeding volume of the observation group were significantly smaller than those of the control group (P<0.05). The time of passage of flatus and time to take food of the observation group were easier than those of the control group, and the duration of hospitalization and parenteral nutrition of the former was significantly shorter than those of the latter, and the difference had statistical significance (P<0.05). The incidence of postoperative complications in the observation group was 2.6%, significantly lower than that in the control group (10.5%) (P<0.05). There was no recurrence in the observation group during the follow-up period, but there were 5 cases of recurrence (13.1%) in the control group; the difference was statistically significant (P<0.05).Conclusion:Compared with the traditional laparotomy, laparoscopic surgery conforms more to the concept of modern medical minimally invasive treatment and has a significant clinical effect in the treatment of congenital choledochal cyst in children. It can effectively promote the disappearance of clinical symptoms and signs, reduce the incidence of postoperative complications and disease recurrence, and improve the surgical efficacy, suggesting high clinical significance and application values.

Highlights

Pediatric choledochal cyst, known as biliary dilatation, is a common clinical biliary malformation disease and congenital abnormality in children.[1,2] In recent years, the incidence of pediatric choledochal cyst is on the rise
Seventy-six children with congenital choledochal cyst who were treated in the hospital between February 2016 and April 2017 were selected as research subjects
No significant difference was found between the two groups in age, gender and weight (P>0.05, Table-I).Compared to the control group, the observation group had smaller surgical incision and less intraoperative blood loss, and the differences were statistically significant (P

Summary

Introduction

Known as biliary dilatation, is a common clinical biliary malformation disease and congenital abnormality in children.[1,2] In recent years, the incidence of pediatric choledochal cyst is on the rise. The incidence of the disease in Asian countries is much higher than that in Europe and America.[3] The main clinical symptoms of pediatric choledochal cyst include intermittent upper abdominal pain, mass and jaundice in right upper abdomen, nausea, vomiting and anorexia.[4] It should be treated by surgery immediately after diagnosis. If the treatment is delayed, severe complications including pancreatitis, Pak J Med Sci May - June 2019 Vol 35 No 3 www.pjms.org.pk 807 pyogeniccholangitis, rupture and perforation of cyst and liver cirrhosis induced by repeated biliary tract infection and obstruction of biliary tract may appear, which can threaten lives of children.[5]

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