Laparoscopic excision of the choledochal cyst in adult patients: An experience.

BACKGROUND

Laparoscopic choledochal cyst excision (LCCE) in adult patients is not common.

AIMS

The aim is to report our experience of LCCE in adult patients.

PATIENTS AND METHODS

This study includes a retrospective review of twenty adult patients (age >18 years) with choledochal cyst (CC) who underwent LCCE by a single surgical team from February 2011 to April 2016.

RESULTS

The mean age was 45.5 years. Nineteen (95%) patients had Type-I CC, and one patient (5%) had Type-IV CC (Todani's classification). Fifteen patients (75%) presented with pain in the abdomen, and five patients (25%) presented with jaundice and/or cholangitis. LCCE was successful in 16 (80%) patients, whereas four patients (20%) required conversion to open method. The reason for conversion was technical difficulty due to the initial learning curve, adhesion and inflammation. The mean blood loss, operation time and post-operative stay were 117.5 ml, 299.5 min and 8.15 days, respectively. Bilioenteric anastomosis leak and formation of pseudoaneurysm occurred in one patient (5%); this patient later died due to uncontrolled intra-abdominal haemorrhage. There were no remote complications during a mean follow-up of 17.2 months.

CONCLUSION

LCCE in adult patients is safe and feasible, but bilioenteric anastomosis leak may have fatal consequences.