Department of Pediatric Surgery, Huai'an Women and Children's Hospital, Huai'an, P.R. China.
J Laparoendosc Adv Surg Tech A. 2024 Mar;34(3):280-283. doi: 10.1089/lap.2023.0229. Epub 2023 Oct 16.
Dilatation of cystic duct is very rare and had been classified as Todani type VI choledochal cyst. Choledochal cyst combined with dilatation of cystic duct is difficult to diagnose preoperatively. The purpose of this study is to report the rare variants and discuss the significance and laparoscopic management strategy in children. The subjects for this study were 10 consecutive patients with type VI choledochal cyst who had laparoscopic procedures at our institute between January 2009 and January 2023. Laparoscopic cholecystectomy, excision of the dilated cystic duct, and choledochal cyst were carried out, and the continuity of the biliary duct was re-established through a Roux-en-Y hepaticojejunostomy. Cystic duct combined with the common bile duct dilatation was revealed in all the patients intraoperatively. Laparoscopic procedures were completed with no conversions. The postoperative recovery was uneventful. The mean follow-up duration was 27 ± 12.7 months (range 5-36 months) with no postoperative complications encountered. The rare entity of type VI choledochal cyst should be recognized as a distinct type of choledochal cyst and need to be given enough attention clinically. The laparoscopic procedure is a feasible option for experienced surgeons.
胆囊管扩张非常罕见，被归类为 Todani 型 VI 胆管囊状扩张症。胆管囊状扩张症合并胆囊管扩张在术前很难诊断。本研究旨在报告罕见的变异，并讨论其在儿童中的意义和腹腔镜处理策略。本研究的对象为 2009 年 1 月至 2023 年 1 月期间在我院接受腹腔镜手术的 10 例连续的 Todani 型 VI 胆管囊状扩张症患者。行腹腔镜胆囊切除术、扩张的胆囊管切除术和胆管囊状扩张切除术，并通过 Roux-en-Y 肝肠吻合术重建胆管的连续性。所有患者术中均发现胆囊管合并胆总管扩张。腹腔镜手术均顺利完成，无中转开腹。术后恢复顺利，无术后并发症。平均随访时间为 27 ± 12.7 个月（5-36 个月）。罕见的 Todani 型 VI 胆管囊状扩张症应被视为一种独特类型的胆管囊状扩张症，在临床上需要给予足够的重视。对于有经验的外科医生来说，腹腔镜手术是一种可行的选择。
