Surgical Endoscopy

, Volume 26, Issue 6, pp 1784–1790 | Cite as

Single-incision laparoscopic Roux-en-Y hepaticojejunostomy using conventional instruments for children with choledochal cysts

  • Mei Diao
  • Long LiEmail author
  • Ning Dong
  • Qi Li
  • Wei ChengEmail author



Single-incision laparoscopy has recently become popular in pediatric surgery. Yet there has been no report on its application in the management of choledochal cysts (CDC). The current series is the first study to evaluate the safety and efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) for CDC in children.


We reviewed 19 children who underwent SILH between April and June 2011. Early postoperative and follow-up results were compared with our historical controls.


The median follow-up period was 3 months. Two procedures were converted to the conventional four-port laparoscopic hepaticojejunostomies. SILH was successfully completed in 17 patients (median age: 3.00 years; F/M: 12/5). Early in the series, one patient developed bile leak, which stopped spontaneously after 10 days of drainage. The mean operative time of the SILH group did not differ from that of our conventional laparoscopic hepaticojejunostomy (CLH) controls (3.06 vs. 3.04 h, P = 0.909). The average postoperative hospital stay, time to full feed, and duration of drainage in the SILH group were comparable to our historical controls of CLH (P = 0.056, 0.472, 0.619, respectively).


In experienced hands, SILH is safe and its short-term results are comparable to CLH. It potentially provides a viable surgical alternative for CDC.


Single-incision Laparoscopy Hepaticojejunostomy Choledochal cysts Children 



Dr. Mei Diao, Prof. Long Li, Dr. Ning Dong, Dr. Qi Li, and Prof. Wei Cheng have no conflicts of interest or financial ties to disclose.


  1. 1.
    Rothenberg SS, Shipman K, Yoder S (2009) Experience with modified single-port laparoscopic procedures in children. J Laparoendosc Adv Surg Tech A 19:695–698PubMedCrossRefGoogle Scholar
  2. 2.
    Hansen EN, Muensterer OJ, Georgeson KE, Harmon CM (2011) Single-incision pediatric endosurgery: lessons learned from our first 224 laparoendoscopic single-site procedures in children. Pediatr Surg Int 27:643–648PubMedCrossRefGoogle Scholar
  3. 3.
    Chow A, Purkayastha S, Paraskeva P (2009) Appendicectomy and cholecystectomy using single-incision laparoscopic surgery (SILS): the first UK experience. Surg Innov 16:211–217PubMedCrossRefGoogle Scholar
  4. 4.
    Tam YH, Lee KH, Sihoe JD, Chan KW, Cheung ST, Pang KK (2010) Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery. J Pediatr Surg 45:2381–2385PubMedCrossRefGoogle Scholar
  5. 5.
    Diao M, Li L, Cheng W (2011) Is it necessary to ligate distal common bile duct stumps after excising choledochal cysts? Pediatr Surg Int 27(8):829–832PubMedCrossRefGoogle Scholar
  6. 6.
    Diao M, Li L, Zhang JZ, Cheng W (2010) A shorter loop in Roux-Y hepatojejunostomy reconstruction for choledochal cysts is equally effective: preliminary results of a prospective randomized study. J Pediatr Surg 45(4):845–847PubMedCrossRefGoogle Scholar
  7. 7.
    Reibetanz J, Wierlemann A, Germer CT, Krajinovic K (2009) A novel technique for fundal retraction of the gallbladder in single-port cholecystectomy. J Laparoendosc Adv Surg Tech A 21:427–429CrossRefGoogle Scholar
  8. 8.
    Diao M, Li L, Cheng W (2011) Laparoscopic versus open Roux-en-Y hepatojejunostomy for children with choledochal cysts: intermediate-term follow-up results. Surg Endosc 25:1567–1573PubMedCrossRefGoogle Scholar
  9. 9.
    Diao M, Li L, Cheng W (2011) To drain or not to drain in Roux-en-Y hepatojejunostomy for children with choledochal cysts in the laparoscopic era: a prospective randomized study. J Pediatr Surg (in press)Google Scholar
  10. 10.
    Broder HL, Smith FB, Strauss RP (1994) Effects of visible and invisible orofacial defects on self-perception and adjustment across developmental eras and gender. Cleft Palate Craniofac J 31:429–436PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryCapital Institute of PediatricsBeijingP. R. China
  2. 2.Department of Paediatric Surgery, Monach Children’s, Monash Medical Center, Southern Health, Department of Paediatrics and Department of Surgery, Southern Medical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonAustralia

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