, Volume 27, Issue 5, pp 1648-1652
Date: 13 Dec 2012

Laparoscopic excision of a choledochal cyst in 82 consecutive patients

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Abstract

Introduction

Despite it being a benign disease, a choledochal cyst must be removed with the gallbladder (GB) due to the risk of cancer in the biliary tract. Most patients are young females or children, all of whom express strong interest in the cosmetic results in addition to the complete resolution of their medical problems. Here, we introduce a laparoscopic management technique for a choledochal cyst.

Methods

Between 2003 and 2011, we performed a laparoscopic choledochal cyst excision procedure on 82 patients using a four-hole method. There were three open-conversion cases, one case involving robotic surgery, and one case involving combined laparoscopic liver resection because the cyst had affected the liver. Excision of the cyst and anastomosis were performed laparoscopically. We will present our method with a video.

Results

The mean operation time was 230 min. The estimated blood loss was 197 ml. The average hospital stay was 8.6 days. The most common complications were minor bile leakage (7 %) and fluid collection (2.5 %), both of which were managed conservatively.

Conclusions

Laparoscopic management can be a treatment of choice for the most instances of choledochal cyst considering its good cosmetic results and its feasible level of operative safety.

Drs. Jin-Young Jang and Yoo-Seok Yoon contributed equally to this work.
Presented at the 20th International Congress of the European Society for Endoscopic Surgery (EAES), June 20–23, 2012, Brussels.