Laparoscopic excision of choledochal cysts with total intracorporeal reconstruction

Jeffrey W. Gander, Robert A. Cowles, Erica R. Gross, Ari R. Reichstein, Anthony C Chin, Jeffrey L. Zitsman, William Middlesworth, Steven S. Rothenberg

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Purpose: There are numerous published reports of laparoscopic resection of choledochal cysts (CDCs), but almost all involve extracorporeal reconstruction of a biliary drainage system. We describe and evaluate the technique of laparoscopic CDC resection with total intracorporeal reconstruction. Methods: We reviewed all patients who underwent a laparoscopic CDC resection from March 2005 to January 2010 at Rocky Mountain Children's Hospital and Children's Hospital of New York-Presbyterian. We obtained data on operative time, characteristics of reconstruction, time to initiation of diet, length of stay, complications, and outcome. Results: Thirteen patients (median age 5 years, range 1-16) underwent a laparoscopic CDC excision with total intracorporeal reconstruction. Four ports were used in all cases and no patients required conversion to an open procedure. Operative time ranged from 130 to 325 minutes (median 240 minutes). Median time to initiation of diet was 1 day (range 1-4 days). Median length of stay was 5 days (range 4-8 days). There were no cases of cholangitis; however, 1 patient developed a small bowel obstruction requiring re-operation. Conclusion: Laparoscopic resection of CDCs with total intracorporeal reconstruction is a safe and effective technique. The minimal handling of the bowel appears to minimize postoperative ileus, allows for early postoperative feeding and discharge.

Original languageEnglish (US)
Pages (from-to)877-881
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume20
Issue number10
DOIs
StatePublished - Dec 1 2010

ASJC Scopus subject areas

  • Surgery

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    Gander, J. W., Cowles, R. A., Gross, E. R., Reichstein, A. R., Chin, A. C., Zitsman, J. L., Middlesworth, W., & Rothenberg, S. S. (2010). Laparoscopic excision of choledochal cysts with total intracorporeal reconstruction. Journal of Laparoendoscopic and Advanced Surgical Techniques, 20(10), 877-881. https://doi.org/10.1089/lap.2010.0123