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One- versus two-stage single-incision laparoscopic cyst excision and hepaticojejunostomy in patients with completely perforated choledochal cysts and good medical conditions

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Abstract

Background

The aim of the current study was to evaluate the efficacy of one- and two-stage single-incision laparoscopic hepaticojejunostomy (SILH) for perforated CDCs with good medical conditions.

Methods

Between June 2015 and December 2020, 57 patients were reviewed: Group 1: patients who underwent one-stage SILH (n = 16); Group 2: patients who underwent two-stage SILH (n = 41). The demographic characteristics, operational details, postoperative outcomes and postoperative complications were evaluated.

Results

The mean follow-up durations of group 1 and 2 were 39.3 and 38.6 months, respectively. One patient (6.3%) in group 1, and 4 patients (9.8%) in group 2 were converted to laparotomy (p = 0.67). No statistical significance was found in operative time, blood transfusion, time to resume full diet, duration of drainage after definitive surgery and postoperative hospital stays between the two groups. Four patients in group 2 developed bile leakage, which was higher than that in group 1 (9.8% vs 0, p = 0.20). None suffered incidental injury, bleeding, anastomotic stenosis, cholangitis, cholelithiasis, pancreatic leakage, pancreatitis, Roux-loop obstruction, adhesive intestinal obstruction or wound infection. Liver function normalized within 1 year postoperatively in both groups.

Conclusions

In experienced hands, one-stage single-incision laparoscopic hepaticojejunostomy is safe and effective for patients with complete perforations and good medical conditions.

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Funding

The project is supported by The Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority, No. XTZD20180304.

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Authors and Affiliations

  1. Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China

    Tong Yin, Suyun Chen, Long Li, Mei Diao & Qianqing Li

  2. Children’s Hospital Capital Institute of Pediatrics, Graduate School of Peking Union Medical College, Beijing, China

    Ting Huang

  3. Beijing Children’s Hospital, Capital Medical University, Beijing, China

    XiangHui Xie

Authors
  1. Tong Yin
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  2. Suyun Chen
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  3. Long Li
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  4. Mei Diao
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  5. Ting Huang
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  6. Qianqing Li
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  7. XiangHui Xie
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Correspondence to Long Li or Mei Diao.

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Yin, T., Chen, S., Li, L. et al. One- versus two-stage single-incision laparoscopic cyst excision and hepaticojejunostomy in patients with completely perforated choledochal cysts and good medical conditions. Pediatr Surg Int 38, 541–545 (2022). https://doi.org/10.1007/s00383-022-05073-7

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  • DOI: https://doi.org/10.1007/s00383-022-05073-7

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