Hepaticoduodenostomy as a technique for biliary anastomosis in children with choledochal cyst

Saxena, Nandita; Kulkarni, Bharati; Borwankar, S. S.; Lahoti, Hemant N; Multani, Pooja; Oak, Sanjay

doi:10.1097/01.xps.0000508440.37104.0d

Cited by 7 publications

(14 citation statements)

References 7 publications

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“…The incidence of the disease in Asian countries is much higher than that in Europe and America 3. The main clinical symptoms of pediatric choledochal cyst include intermittent upper abdominal pain, mass and jaundice in right upper abdomen, nausea, vomiting and anorexia 4. It should be treated by surgery immediately after diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Surgery in the treatment of children with Choledochal Cyst

Qu¹,

Cui²,

Xu³

2019

Pak J Med Sci

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Objective: To evaluate the clinical effectiveness of laparoscopic surgery in the treatment of children with choledochal cyst. Methods: Seventy-six children with congenital choledochal cyst who were admitted to our hospital between February 2016 and April 2017 were selected as research subjects. They were evenly divided into an observation group and a control group using random number table, 38 each group. Patients in the observation group underwent laparoscopic surgery, while patients in the control group underwent the traditional laparotomy. Surgery related indicators and prognosis were compared between the two groups. Results: The incision size and intraoperative bleeding volume of the observation group were significantly smaller than those of the control group (P<0.05). The time of passage of flatus and time to take food of the observation group were easier than those of the control group, and the duration of hospitalization and parenteral nutrition of the former was significantly shorter than those of the latter, and the difference had statistical significance (P<0.05). The incidence of postoperative complications in the observation group was 2.6%, significantly lower than that in the control group (10.5%) (P<0.05). There was no recurrence in the observation group during the follow-up period, but there were 5 cases of recurrence (13.1%) in the control group; the difference was statistically significant (P<0.05). Conclusion: Compared with the traditional laparotomy, laparoscopic surgery conforms more to the concept of modern medical minimally invasive treatment and has a significant clinical effect in the treatment of congenital choledochal cyst in children. It can effectively promote the disappearance of clinical symptoms and signs, reduce the incidence of postoperative complications and disease recurrence, and improve the surgical efficacy, suggesting high clinical significance and application values. doi: https://doi.org/10.12669/pjms.35.3.85 How to cite this:Qu X, Cui L, Xu J. Laparoscopic Surgery in the treatment of children with Choledochal Cyst. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.85 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic Surgery in the treatment of children with Choledochal Cyst

Qu¹,

Cui²,

Xu³

2019

Pak J Med Sci

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“…Hepatico-duodenostomy has reported as an alternative technique of Roux-en-Y Hepatico-jejunostomy solves some of these complications and accepted as a more physiological procedure. 3,9 Maximum number of patients (43.75%) in this series underwent hepatico-duodenostomy and one patient has mild leakage in the early postoperative period. Till date, overall complications rate are low and comparable to other center.…”

Section: Discussionmentioning

confidence: 92%

“…Till date, overall complications rate are low and comparable to other center. 3 Choledocho-cholecysto-duodenostomy is a new technique introduced by an author that uses native biliary channel for bile drainage instead of intestinal conduit. No significant early complications have been observed in the new technique.…”

Section: Discussionmentioning

confidence: 99%

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Surgical management of choledocal cyst in different techniques: a 4-year experience

Das¹,

Hasina²,

Huq³

et al. 2020

MOJS

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“…Hepatico-duodenostomy is still performed in some units; however, other centres have changed to RYBD because of bile reflux and incidental malignancy [20][21][22][23]. Other alternates that have been used were the gallbladder, an ileal loop between the hepatic duct and jejunum, and an isolated vascularized jejunal tube that has also been successfully used in an animal study [1,3,4].…”

Section: Discussionmentioning

confidence: 99%

Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

et al. 2021

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Background Despite the enormous surgical advancements in the last century, access to the biliary system is lost when a Roux-en-Y (RY) biliary drainage procedure is performed. Attempts have been made to overcome this inconvenient sequel using variations in the RY anastomosis, small bowel grafts and vascular grafts. These have been predominantly unsuccessful. An isolated vascularized gastric tube (IVGT) graft has been reported in the literature, which was successfully used for adult patients with common bile duct injuries. We have adopted the technique of using an IVGT graft for bile duct reconstruction in the paediatric patients at our institution. We reviewed our experience at our institution between January 2015 and October 2019. This was a retrospective review of all paediatric patients undergoing an IVGT graft procedure for biliary tract anatomical obstruction in the past 5 years. We looked at the indications for surgery, the demographic profile of the patients and outcomes following surgery and outlined the surgical technique used. Results IVGT bile duct reconstruction was performed on eight patients. Patients ranged from 2 months to 7 years, and there was an equal number of males and females. The diagnosis was made on clinical suspicion and confirmed with ultrasound (U/S) and magnetic resonance cholangiopancreatography (MRCP). There was an 87.5% resolution of biliary obstruction, and two patients who had bile leaks postoperatively were managed conservatively. Unfortunately, one patient died in the early postoperative period from sepsis due to pneumonia. Follow-up was for a minimum of 6 months and up to 5 years. Conclusion IVGT biliary enteric drainage is a safe, reproducible procedure that allows access to the biliary tree if required in the future. Thus, this procedure serves as an alternative, especially in limited-resource areas where interventional radiology is not available for future interventions.

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Hepaticoduodenostomy as a technique for biliary anastomosis in children with choledochal cyst

Cited by 7 publications

References 7 publications

Laparoscopic Surgery in the treatment of children with Choledochal Cyst

Laparoscopic Surgery in the treatment of children with Choledochal Cyst

Surgical management of choledocal cyst in different techniques: a 4-year experience

Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

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