Single-stage operation for perforated choledochal cyst.

J Pediatr Surg

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.

Published: April 2018

Background: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs.

Methods: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B). The operative time, intraoperative bleeding, length of stay, and postoperative complications were analyzed.

Results: Group A comprised 6 patients (2 males, 4 females; mean age, 29months), and Group B comprised 26 patients (2 males, 24 females; mean age, 41months). All patients underwent single-stage complete excision with Roux-en-Y hepaticojejunostomy. There were no significant differences in the operative time, bleeding, and/or length of stay. There were no operative deaths or complications such as anastomosis leakage or postoperative cholangitis, but a pancreatic fistula developed in one patient in Group A and two in Group B.

Conclusion: Single-stage excision for a perforated CC is feasible if the patient's condition is stable.

Levels Of Evidence: Treatment Study, LEVELIII.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpedsurg.2017.07.014DOI Listing

Publication Analysis

Top Keywords

perforated choledochal
8
single-stage excision
8
excision perforated
8
ccs group
8
operative time
8
length stay
8
group comprised
8
comprised patients
8
patients males
8
males females
8

Similar Publications

Choledochal Cyst and Right Congenital Diaphragmatic Hernia: When to Intervene?

European J Pediatr Surg Rep

January 2024

Division of Pediatric Surgery, CHU Sainte-Justine, Montreal, Quebec, Canada.

Article Synopsis
  • Patients with congenital diaphragmatic hernia (CDH) may have other congenital issues, like choledochal cysts (CC), which complicate treatment; there's no clear agreement on when to surgically remove a CC.
  • Leaving a CC unrepaired can lead to serious complications such as biliary sludge and infections, while repairing it too early could cause problems with the CDH mesh used in previous surgeries.
  • A rare case is presented where a neonate with CDH developed a previously undetected CC, leading to surgery after severe complications, but ultimately, the patient recovered well and has normal liver function after 12 months.
View Article and Find Full Text PDF

Background: Matrix metalloproteinase-7 (MMP-7) is associated with biliary injury. This study aimed to evaluate the relationships of serum MMP-7 with clinical characteristics in choledochal cysts (CDC) children.

Methods: Between June 2020 and July 2022, we conducted a prospective study of CDCs who underwent one-stage definitive operation at our center.

View Article and Find Full Text PDF

A nomogram for predicting choledochal cyst with perforation.

Pediatr Surg Int

May 2024

Department of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Background: Choledochal cyst with perforation (CC with perforation) rarely occurs, early diagnosis and timely treatment plan are crucial for the treatment of CC with perforation. This study aims to forecast the occurrence of CC with perforation.

Methods: All 1111 patients were conducted, who underwent surgery for choledochal cyst at our hospital from January 2011 to October 2022.

View Article and Find Full Text PDF

Antenatally Detected Choledochal Malformation: What Are We Waiting For?

J Pediatr Surg

September 2024

Dept. of Paediatric Surgery, Kings College Hospital, London SE5 9RS, United Kingdom. Electronic address:

Introduction: An increasing proportion of congenital choledochal malformation (CCM) are being detected on antenatal ultrasound. However, the actual timing of its surgical correction remains controversial with some series showing an excess of complications the earlier the operation. The aim of this study was to characterize the pathophysiological aspects of this cohort from the perspective of age at surgery in order to inform a more rational basis for clinical decision-making.

View Article and Find Full Text PDF

Cholangiocarcinoma in patients with Choledochal cysts is rare in childhood; however, it seriously affects the prognosis of the disease. The key to addressing this situation lies in completely removing the extrahepatic cyst. We herein present a case report of a 3-year-old boy with cholangiocarcinoma associated with a choledochal cyst (CDC).

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!