Abstract
The purpose of this study is to introduce our preliminary experiences with using the da Vinci surgical system to treat choledochal cysts in children under 1 year old and discuss the application of this robot-assisted surgery. We retrospectively analyzed all available clinical data of children below the age of 1 who underwent surgery for choledochal cysts using the da Vinci robotic surgical system between January 2015 and December 2020. Data collection mainly included demographic information, imaging data, perioperative details, and postoperative outcomes. Ten patients were included in this study. The average patient age was 8.5 months, and the average weight was 9.11 kg. Half of these patients suffered from abdominal pain, while 30% exhibited vomiting and 10% jaundice. Eight of them were type Ia, and two were Ic. The average operation time among the patients was 219.5 min. None of the 10 patients had to receive a blood transfusion or conversion. The average time of the patients' subsequent fluid diet was 3.28 days, and the solid diet was 3.76 days. Meanwhile, the average length of hospital stay was 7.6 days. All 10 patients recovered and were eventually discharged. We believe that the da Vinci surgical system is a safe and feasible form of treatment for choledochal cysts in children <1 year old.
Highlights
Choledochal cysts are the most common congenital malformation found in the biliary tract and are characterized by cystic or fusiform dilatation of the common bile duct
10 cases were in children below the age of 1, and in this study, we present our experiences and discuss the relevant technical points
Candidates for inclusion in the study were based on the following requirements: [1] patients were diagnosed with choledochal cysts through preoperative history, physical examination, B-ultrasound, computed tomography (CT), or magnetic resonance cholangiopancreatography (MRCP); [2] patients would be able to tolerate CO2 pneumoperitoneum during general anesthesia and robotic surgery; and [3] the patient’s coagulation function was normal, and they had no serious organ dysfunction
Summary
Choledochal cysts are the most common congenital malformation found in the biliary tract and are characterized by cystic or fusiform dilatation of the common bile duct. These have been known to simultaneously appear alongside intrahepatic bile duct dilatation [1,2,3]. Patients with choledochal cysts may suffer from cyst perforation, recurrent pancreatitis, cancer, or even severe cholestasis, which can lead to liver cirrhosis, portal hypertension, and eventually liver failure [4]. The best option for treatment of choledochal cysts is surgery, which mainly involves choledochal cyst resection, cholecystectomy, and hepaticojejunostomy [5]. The laparoscopic procedure is as of yet not widely
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