The application of three different biliary tract reconstruction by laparoscopy in the treatment of congenital choledochal cyst

Abstract

Objective To investigate the clinical efficacy and safety of three kinds of biliary reconstruction after laparoscopic choledochal cyst resection, including hepatic duct duodenal anastomosis, hepatic duct jejunal Roux-en-Y anastomosis and modified choledocho loop anastomosis. Methods The clinical data from 46 cases of congenital choledochal cyst treated in our hospital from January 2012 to December 2016 were retrospectively analyzed. 15 cases of hepatic duodenostomy (group A), 17 cases of Roux-en-Y hepaticojejunostomy (group B) and 14 cases of Modified biliary-enteric Warren Anastomosis (group C) were performed respectively after the resection of choledochal cyst. SPSS19.0 software package was used for statistical description and analysis of data. Biochemical indicators and perioperative indicators were measured by means of (±s) and compared with one-way ANOVA. Recent complications and other classification data were described by frequency (constituent ratio). Pearson chi square test was used for comparison between the two groups. P<0.05 was statistically significant. Results The operative time, postoperative ventilation time, drainage tube retention time and postoperative hospital stay in group C were shorter than those in group A and B, and the difference was statistically significant (P 0.05). Conclusion Compared with hepatic duodenostomy and hepatic duct jejunum Roux-en-Y anastomosis surgery, laparoscopic modified loop type biliary enteric anastomosis has the similar results, shorter operative time, better postoperative gastrointestinal function recovery and shorter postoperative hospitalization time, which is worthy of promotion. Key words: Choledochal Cyst; Laparoscopes; Choledochostomy; Anastomosis, Roux-en-Y