Early Experience of Laparoscopic Management of Choledochal Cyst

ABSTRACT

PURPOSE: The total excision of choledochal cyst with gallbladder is a treatment of choice due to the high risk of the development of cancer in a biliary tree. The cosmetic result as well as cure of disease is important in the management of this disease. Here we report the early experience of totally laparoscopic excision of a choledochal cyst and hepaticojejunostomy using 4 holes methods. METHODS: Between October 2003 and May 2005, we performed totally laparoscopic choledochal cyst excision in twelve patients. All were female except one male with a mean age 37.3 (range 17~62) years. According to the Todani classification, five were type Ia, four type Ic and three type IV. Choledochal cyst excision and Roux-en-Y hepaticojejunostomy was entirely performed laparoscopically using 4 port technique. RESULTS: The mean operation time was 228 (150~330) minutes. There was no operative or postoperative transfusion. An oral diet was started on the 3rd operative day. The average length of hospital stay was 5.8 days. There was no major complication associated with anastomosis leakage or obstruction. All patients have showed no specific symptoms or laboratory abnormalities during 2~19 months follow-up periods. CONCLUSION: Considering that choledochal cyst is common in young ages and females, who are especially interested in cosmetic results as well as cure of disease, laparoscopic management of choledochal cyst can be an attractive treatment option.