Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Surg Endosc. 2013 May;27(5):1648-52. doi: 10.1007/s00464-012-2646-0. Epub 2012 Dec 13.
Despite it being a benign disease, a choledochal cyst must be removed with the gallbladder (GB) due to the risk of cancer in the biliary tract. Most patients are young females or children, all of whom express strong interest in the cosmetic results in addition to the complete resolution of their medical problems. Here, we introduce a laparoscopic management technique for a choledochal cyst.
Between 2003 and 2011, we performed a laparoscopic choledochal cyst excision procedure on 82 patients using a four-hole method. There were three open-conversion cases, one case involving robotic surgery, and one case involving combined laparoscopic liver resection because the cyst had affected the liver. Excision of the cyst and anastomosis were performed laparoscopically. We will present our method with a video.
The mean operation time was 230 min. The estimated blood loss was 197 ml. The average hospital stay was 8.6 days. The most common complications were minor bile leakage (7 %) and fluid collection (2.5 %), both of which were managed conservatively.
Laparoscopic management can be a treatment of choice for the most instances of choledochal cyst considering its good cosmetic results and its feasible level of operative safety.
尽管胆总管囊肿是一种良性疾病,但由于胆道癌的风险,必须将其与胆囊(GB)一起切除。大多数患者为年轻女性或儿童,他们除了完全解决医疗问题外,还对美容效果表示强烈关注。在这里,我们介绍一种腹腔镜治疗胆总管囊肿的方法。
2003 年至 2011 年间,我们使用四孔法对 82 例患者进行了腹腔镜胆总管囊肿切除术。有 3 例中转开腹手术,1 例机器人手术,1 例联合腹腔镜肝切除术,因为囊肿已影响肝脏。囊肿切除和吻合均在腹腔镜下进行。我们将通过视频展示我们的方法。
平均手术时间为 230 分钟。估计失血量为 197 毫升。平均住院时间为 8.6 天。最常见的并发症是轻微胆漏(7%)和积液(2.5%),均保守治疗。
考虑到良好的美容效果和可行的手术安全性,腹腔镜治疗可以成为大多数胆总管囊肿的治疗选择。