Using laparoscopic double hemicircumferential running single-layer suture in hepaticojejunostomy for choledochal cysts in children

Abstract

BackgroundTo evaluate the feasibility and effectiveness of implementing a double-hemicircumferential running suture in laparoscopic hepaticojejunostomy for choledochal cysts (CDC) in children. MethodsFrom October 2001 to October 2009, we performed Roux-en-Y hepaticojejunostomy for 218 patients with congenital choledochal cyst. The choledochal cysts were excised laparoscopically. The jejunal Roux loop was fashioned extracorporeally by using hand-suturing technique. Laparoscopic “double-hemicircumferential” end to side anastomosis between the common hepatic duct stump and Roux loop was carried out. Early postoperative and follow-up results were analysed. ResultsDouble-hemicircumferential running suture was conducted for hepaticojejunostomy on 218 patients with choledochal cyst. The mean anastomosis time was 13.5±2.5min, and average bleeding amount was 9.1±6.1ml. The average postoperative hospital stay time was 7.4±2.4days. The median follow-up period was 122months. Morbidities associated with anastomosis, such as anastomotic stenosis, cholangitis, and stone formations do not occurred during follow-up period. ConclusionsThe double-hemicircumferential running suture technique has the advantages of easy to operate in laparoscopy, saving time and less complications, thus it is an effective improvement of hepaticojejunostomy for choledochal cyst.