RESUMO
The authors present a 5-year-old girl with a congenital choledochal cyst and repeated cholangitis. On laparoscopy, a type I choledochal cyst of Todani classification was confirmed. The cyst was excised laparoscopically. After exteriorization of the small bowel through the umbilical incision, a Roux-en Y anastomosis was performed. Then the bowel was reintroduced into the abdominal cavity and a laparoscopic end-to-side hepaticojejunostomy was carried out. There were not intra or post operative problems. Oral food intake started at 72 hours and the patient was discharged on day 5 without complications and with excellent cosmetic results. We conclude that laparoscopic techniques are an excellent option for the resection of congenital choledochal cyst and hepaticojejunostomy in children.
Assuntos
Cisto do Colédoco/cirurgia , Laparoscopia/métodos , Pré-Escolar , Feminino , HumanosRESUMO
Presentamos el caso de una paciente de 5 años con quiste de colédoco y repetidas crisis de colangitis. La colangiografía realizada durante la intervención confirmó la existencia de un quiste tipo I de Todani. La resección del quiste se realizó íntegramente por laparoscopia. El montaje en Y de Roux se realizó exteriorizando las asas intestinales a través del puerto umbilical. Tras la reintroducción del montaje en la cavidad abdominal, la anastomosis hepatoentérica (termino- lateral) se realizó mediante técnica laparoscópica. No hubo problemas intraoperatorios y el postoperatorio cursó sin incidencias, iniciándose la alimentación oral a las 72 horas de la intervención con una rápida recuperación postoperatoria que permitió que la paciente fuera dada de alta al 5º día de la intervención. Tras 6 meses de seguimiento postoperatorio, la paciente se encuentra clínicamente asintomática y con excelentes resultados estéticos. Consideramos que la aplicación de las técnicas laparoscópicas es una excelente opción para la resección del quiste de colédoco congénito y la derivación bilioentérica en el paciente pediátrico (AU)
The authors present a 5-year-old girl with a congenital choledochal cyst and repeated cholangitis. On laparoscopy, a type I choledochal cyst of Todani classification was confirmed. The cyst was excised laparoscopically. After exteriorization of the small bowel through the umbilical incision, a Roux-en Y anastomosis was performed. Then the bowel was reintroduced into the abdominal cavity and a laparoscopic end-to-side hepaticojejunostomy was carried out. There were not intra or post operative problems. Oral food intake started at 72 hours and the patient was discharged on day 5 without complications and with excellent cosmetic results. We conclude that laparoscopic techniques are an excellent option for the resection of congenital choledochal cyst and hepaticojejunostomy in children (AU)
