Laparoscopic total cyst excision with Roux-en-Y hepatojejunostomy for neonates with choledochocyst

Abstract

Objective To assess the feasibility and safety of laparoscopic total cyst excision with Roux-en-Y hepatojejunostomy for choledochocyst in neonates.Methods This study was carried out on 9 neonates with symptom of jaundice(8cases),pale stools(5 cases),elevated AST and ALT(9 cases)between April 2003 and February 2007.Their age ranged from 13 to 28 days(average,24 days).The choledochal cysts were of cystic type in all cases with the average diameter of 3.8 cm(range,2.5 to 8cm).The 9 neonates with choledochoyst underwent laparoscopic cyst excision with Roux-en-Y hepatojejunostomy successfully.All of cases were followed up for a mean period of 26 months(range,3 to 45months).Results Average duration of operation was 3.6 hours(range,3.3 to 4.0 hours)without intraoperative complication.Intraoperative bleeding was 5 to 10 ml.Patients passed flatus post-operatively in 18 hours(range,16 to 28 hours);resumed oral food intake in 20 hours(range,16 to 30 hours),and passed bile stained stools on day 1.5(range,1 to 3 days).The postoperative course was uneventful with mean hospital stay of 6.3 days(range,4 to 9 days).There was no postoperative complication during the followed-up visits.Conclusions Laparoscopic total cyst excision with Roux-en-Y hepatojejunostomy for neonates with choledochocyst is feasible,safe and effective. Key words: Choledochal cyst; Anastomosis,Roux-en-Y; Laparoscopic surgical procedurea