Between 1984 and 2021, we performed choledochal cyst (CC) excision on 256 children at our center. Out of this group, we retrospectively reviewed the medical records of 59 patients operated on under one year of age. All of them underwent total cyst resection with end-to-side Roux-en-Y hepaticojejunostomy.
The open procedure was based on a right subcostal incision, total cyst resection, creation of a 40 cm length Roux-en-Y jejunal loop, and end-to-side hepaticojejunostomy. Since 2015, a laparoscopic approach for choledochal cyst resection has become our institution’s surgical method of choice. We used a 30° laparoscope introduced to the abdominal cavity through the umbilical incision and three ports of 3–5 mm (Figure 1 ). Transcutaneous traction sutures through the gallbladder and falciform ligament were used for better liver hilum exposure. A Roux-en-Y loop was created extra abdominally through the widened umbilical incision and returned to the abdomen. The end-to-side anastomosis was performed intraabdominally with interrupted monofilament absorbable 5/0 or 6/0 sutures (Figure 2 ).
All patients were followed postoperatively at 1, 3, 6 months, and every 12 months after surgery. Physical examination, liver function tests, and ultrasound examinations were retrospectively analyzed.
Standard demographic variables included age, gender, body weight, time of diagnosis, and presence of clinical symptoms during the preoperative period. We analyzed intraoperative, early, and late complications. The patients were subsequently divided into groups based on: the presence of symptoms in the preoperative period (asymptomatic vs. symptomatic), time of diagnosis (prenatal vs. postnatal), and surgical access (laparoscopy vs. laparotomy). We compared patients between groups for their demographic data, laboratory findings, and surgical outcomes. Complications were defined as early (<30 days after CC resection) or late (>30 days after CC resection).
The open procedure was based on a right subcostal incision, total cyst resection, creation of a 40 cm length Roux-en-Y jejunal loop, and end-to-side hepaticojejunostomy. Since 2015, a laparoscopic approach for choledochal cyst resection has become our institution’s surgical method of choice. We used a 30° laparoscope introduced to the abdominal cavity through the umbilical incision and three ports of 3–5 mm (
All patients were followed postoperatively at 1, 3, 6 months, and every 12 months after surgery. Physical examination, liver function tests, and ultrasound examinations were retrospectively analyzed.
Standard demographic variables included age, gender, body weight, time of diagnosis, and presence of clinical symptoms during the preoperative period. We analyzed intraoperative, early, and late complications. The patients were subsequently divided into groups based on: the presence of symptoms in the preoperative period (asymptomatic vs. symptomatic), time of diagnosis (prenatal vs. postnatal), and surgical access (laparoscopy vs. laparotomy). We compared patients between groups for their demographic data, laboratory findings, and surgical outcomes. Complications were defined as early (<30 days after CC resection) or late (>30 days after CC resection).
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