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World Journal of Surgery

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01-10-2015 | Original Scientific Report

Laparoscopic Management of Choledochal Cyst-Technical Modifications and Outcome Analysis

Authors: Palanisamy Senthilnathan, Nikunj D. Patel, Arun S. Nair, V. P. Nalankilli, Anand Vijay, Chinnusamy Palanivelu

Published in: World Journal of Surgery | Issue 10/2015

Abstract

Background

Choledochal cyst (CDC) is a well described albeit rare clinical entity. Complete cyst excision with biliary-enteric reconstruction is the recommended treatment for Todani type I, II, and IVA cysts to prevent complications. The aim of this study is to evaluate outcomes of laparoscopic CDC excision from a tertiary care center.

Methods

This is a retrospective analysis of prospectively collected data of 110 patients who underwent laparoscopic cyst excision and biliary-enteric reconstruction for CDC type I and IVA from 1998 to 2013.

Results

Out of 110 patients, 55 were children (<16 years) and 55 were adults (>16 years) with mean age 21.19 ± 17.75 years and male:female ratio of 1:2.14. Abdominal pain was the most common presenting symptom (59.09 %). Surprisingly, 32.73 % of adults presented with incidentally detected cyst. Type I cyst was the most common (71.82 %) with mean size of 4.67 ± 1.59 cm. Blood loss (56.0 ± 16.62 vs. 76.55 ± 26.61 ml) and operative time (199.8 ± 44.66 vs. 251.6 ± 54.25 min) were significantly low in pediatric group. Three adults required conversion. Overall complication rate was 10 %. Re-exploration rate was 1.81 % with one patient died post-operatively. Mean hospital stay was significantly low in children (5.9 ± 1.39 vs. 7.0 ± 2.66 days). Median follow-up was 60 months (8–110). Cholangitis developed in six patients with three having anastomotic stricture requiring intervention.

Conclusion

Laparoscopic excision of CDC is safe and feasible. Surgery should be performed early as outcomes are better in pediatric age as compared to adults.

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Title: Laparoscopic Management of Choledochal Cyst-Technical Modifications and Outcome Analysis
Authors: Palanisamy Senthilnathan
Nikunj D. Patel
Arun S. Nair
V. P. Nalankilli
Anand Vijay
Chinnusamy Palanivelu
Publication date: 01-10-2015
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 10/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3111-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic Management of Choledochal Cyst-Technical Modifications and Outcome Analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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