Advertisement

Pediatric Surgery International

, Volume 34, Issue 10, pp 1087–1092 | Cite as

Introduction of resection of intrahepatic bile duct stenosis-causing membrane or septum into laparoscopic choledochal cyst excision

  • Yujiro TanakaEmail author
  • Takahisa Tainaka
  • Wataru Sumida
  • Akinari Hinoki
  • Chiyoe Shirota
  • Naruhiko Murase
  • Kazuo Oshima
  • Ryo Shirotsuki
  • Kosuke Chiba
  • Hiroo Uchida
Original Article
  • 142 Downloads

Abstract

Purpose

We previously showed that meticulous probing and resection of the intrahepatic bile duct stenosis (IHBDS)-causing membrane or septum was effective in preventing hepatolithiasis after choledochal cyst excisions in open surgeries. Then, we introduced this maneuver into laparoscopic choledochal cyst excisions in 2014 and performed routine resections since then. The aim of this study was to show the feasibility of this method in laparoscopic surgery.

Methods

We retrospectively reviewed the demographics and outcomes of patients who underwent laparoscopic choledochal cyst excisions at our hospital between January 2014 and December 2017. The patients who underwent surgical treatment for IHBDS-causing membrane or septum were compared with those who did not undergo the procedure. The outcomes of the patients with IHBDS were also compared between patients who were ≥ 3 years of age and those < 3 years at operation.

Results

Seventeen of 35 patients underwent laparoscopic resection of IHBDS-causing membrane or septum. There were no complications related to the procedure although the operative time and intraoperative bleeding amount increased in the patients with IHBDS who were ≥ 3 years of age.

Conclusions

Meticulous probing and excision of the IHBDS-causing membrane or septum is safe and feasible during laparoscopic choledochal cyst excision.

Keywords

Laparoscopic surgery Choledochal cyst Bile duct stenosis Ductoplasty 

Notes

Compliance with ethical standards

Conflict of interest

No competing financial interests exist.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Tanaka Y, Tainaka T, Sumida W, Shirota C, Hinoki A, Murase N, Oshima K, Shirotsuki R, Chiba K, Uchida H (2017) The efficacy of resection of intrahepatic bile duct stenosis-causing membrane or septum for preventing hepatolithiasis after choledochal cyst excision. J Pediatr Surg 52:1930–1933.  https://doi.org/10.1016/j.jpedsurg.2017.08.056 CrossRefPubMedGoogle Scholar
  2. 2.
    Ando H, Kaneko K, Ito F, Seo T, Ito T (1997) Operative treatment of congenital stenoses of the intrahepatic bile ducts in patients with choledochal cysts. Am J Surg 173:491–494CrossRefPubMedGoogle Scholar
  3. 3.
    Li L, Liu SL, Hou WY, Cui L, Liu XL, Jun Z, Liu-Ming H, Gang L, Kamal NA (2008) Laparoscopic correction of biliary duct stenosis in choledochal cyst. J Pediatr Surg 43:644–646.  https://doi.org/10.1016/j.jpedsurg.2007.10.064 CrossRefPubMedGoogle Scholar
  4. 4.
    Tang ST, Yang Y, Wang Y, Mao YZ, Li SW, Tong QS, Cao GQ, Zhao ZX (2011) Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases. Surg Endosc 25:416–422.  https://doi.org/10.1007/s00464-010-1183-y CrossRefPubMedGoogle Scholar
  5. 5.
    Wang J, Zhang W, Sun D, Zhang Q, Liu H, Xi D, Li A (2012) Laparoscopic treatment for choledochal cysts with stenosis of the common hepatic duct. J Am Coll Surg 214:e47–e52.  https://doi.org/10.1016/j.jamcollsurg.2012.03.001 CrossRefPubMedGoogle Scholar
  6. 6.
    Diao M, Li L, Cheng W (2013) Role of laparoscopy in treatment of choledochal cysts in children. Pediatr Surg Int 29:317–326.  https://doi.org/10.1007/s00383-013-3266-z CrossRefPubMedGoogle Scholar
  7. 7.
    Li S, Wang W, Yu Z, Xu W (2014) Laparoscopically assisted extrahepatic bile duct excision with ductoplasty and a widened hepaticojejunostomy for complicated hepatobiliary dilatation. Pediatr Surg Int 30:593–598.  https://doi.org/10.1007/s00383-014-3501-2 CrossRefPubMedGoogle Scholar
  8. 8.
    Saito T, Hishiki T, Terui K, Sato Y, Mitsunaga T, Terui E, Nakata M, Takenouchi A, Matsuura G, Yahata E, Ohno S, Sato H, Yanagawa N, Masuda Y, Yoshida H (2011) Use of preoperative, 3-dimensional magnetic resonance cholangiopancreatography in pediatric choledochal cysts. Surgery 149:569–575.  https://doi.org/10.1016/j.surg.2010.11.004 CrossRefPubMedGoogle Scholar
  9. 9.
    Todani T, Watanabe Y, Urushihara N, Noda T, Morotomi Y (1995) Biliary complications after excisional procedure for choledochal cyst. J Pediatr Surg 30:478–481CrossRefPubMedGoogle Scholar
  10. 10.
    Stringer MD (2007) Wide hilar hepaticojejunostomy: the optimum method of reconstruction after choledochal cyst excision. Pediatr Surg Int 23:529–532.  https://doi.org/10.1007/s00383-007-1929-3 CrossRefPubMedGoogle Scholar
  11. 11.
    Ono S, Fumino S, Shimadera S, Iwai N (2010) Long-term outcomes after hepaticojejunostomy for choledochal cyst: a 10- to 27-year follow-up. J Pediatr Surg 45:376–378.  https://doi.org/10.1016/j.jpedsurg.2009.10.078 CrossRefPubMedGoogle Scholar
  12. 12.
    Ando H, Ito T, Kaneko K, Seo T (1995) Congenital stenosis of the intrahepatic bile duct associated with choledochal cysts. J Am Coll Surg 181:426–430PubMedGoogle Scholar
  13. 13.
    Kemmotsu H, Mouri T, Muraji T (2009) Congenital stenosis of the hepatic duct at the porta hepatis in children with choledochal cyst. J Pediatr Surg 44:512–516.  https://doi.org/10.1016/j.jpedsurg.2008.06.011 CrossRefPubMedGoogle Scholar
  14. 14.
    Lilly JR (1978) Total excision of choledochal cyst. Surg Gynecol Obstet 146:254–256PubMedGoogle Scholar
  15. 15.
    Lal R, Agarwal S, Shivhare R, Kumar A, Sikora SS, Saxena R, Kapoor VK (2005) Type IV-A choledochal cysts: a challenge. J Hepatobiliary Pancreat Surg 12:129–134.  https://doi.org/10.1007/s00534-004-0960-1 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Yujiro Tanaka
    • 1
    Email author
  • Takahisa Tainaka
    • 1
  • Wataru Sumida
    • 1
  • Akinari Hinoki
    • 1
  • Chiyoe Shirota
    • 1
  • Naruhiko Murase
    • 1
  • Kazuo Oshima
    • 1
  • Ryo Shirotsuki
    • 1
  • Kosuke Chiba
    • 1
  • Hiroo Uchida
    • 1
  1. 1.Department of Pediatric SurgeryNagoya University Graduate School of MedicineNagoyaJapan

Personalised recommendations