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Roux-en-y choledochal cyst

Ana Karen Medina Lira, Argenis Jose Mayorga Soto, Pamela Frigerio
BACKGROUND: Choledochal cyst is a congenital dilatation of the biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Vater first described choledochal cyst in 1723. Open excision was the standard procedure made a great impact in the treatment but since 1995 Farello et al. first reported laparoscopic choledochal cyst excision and this has been used worldwide. CASE REPORT: Female, 17 years old, past medical history two years ago a laparoscopic cholecystectomy for gallbladders...
October 5, 2016: International Journal of Surgery Case Reports
Yingming Tang, Fei Li, Guoqing He
The purpose of this study was to elucidate the potential benefits of single-incision laparoscopic Roux-en-Y hepaticojejunostomy comparing the conventional laparoscopic procedures. From January 2013 to July 2013, 17 consecutive children with choledochal cysts received single-incision laparoscopic Roux-en-Y hepaticojejunostomies by a single surgeon at our institution. Seventeen standard laparoscopic hepaticojejunostomies of consecutive children with choledochal cysts from July 2012 to December 2012 were employed as control...
August 2016: Indian Journal of Surgery
Cüneyt Kayaalp, Vural Soyer, Veysel Ersan, Cemalettin Aydın, Servet Karagül
Congenital choledochal cysts are rare in adults. Due to the risk of developing cholangiocarcinoma, the current standard of care is complete excision of the cyst and reconstruction with hepaticojejunostomy. So far, more than 200 laparoscopic resections have been reported in adults, the majority being from Far Eastern countries over the last five years. Herein, the technique of laparoscopic type I choledochal cyst excision and hepaticojejunostomy is presented in a 37-year-old male with an accompanying video. The advantages of laparoscopic surgery are applicable for choledochal cyst excision as well...
2016: Ulusal Cerrahi Dergisi
Mario Lima, Tommaso Gargano, Giovanni Ruggeri, Francesca Destro, Michela Maffi
Choledochal cyst (CDC) is a congenital dilatation of the extra and/or intrahepatic bile ducts and it is a rare condition in western countries. Classical treatment consists of cyst excision and hepaticojejunostomy. The first case of a laparoscopic CDC excision was described in 1995 and since that time an increasing number of institutions have adopted this technique, with good success. We describe our early experience of 3 cases of CDC treated with laparoscopic approach. We used a 10 mm umbilical port for the camera, and four 3-5 mm operative ports...
2016: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Zhe Wen, Huiying Liang, Jiankun Liang, Qifeng Liang, Huimin Xia
INTRODUCTION: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst (CDC) in children. However, the learning curve for this challenging laparoscopic procedure has not been addressed. The aim of this study is to determine the characteristics of the learning curve of this procedure. This may guide the training in institutions currently not using this technique. METHODS: A prospectively collected database comprising all medical records of the first 104 consecutive patients undergoing laparoscopic CDC excision and Roux-en-Y hepaticojejunostomy performed by one surgeon was studied...
June 23, 2016: Surgical Endoscopy
Maitham A Moslim, Hideo Takahashi, Federico G Seifarth, R Matthew Walsh, Gareth Morris-Stiff
BACKGROUND: The aim of this study was to report a Western experience in the diagnosis and management of choledochal cyst disease. RESULTS: Sixty-seven patients were identified including 15 children and 52 adults; 76.1 % were females. The median age at diagnosis was 3 [inter-quartile range (IQR) = 6.0-0.7] years for children, and 46 [IQR = 55.6-34.3] years for adults. Forty-eight patients (72 %) were symptomatic. Types of choledochal cyst included: I (n = 49, 73...
August 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jun Suh Lee, Young Chul Yoon
PURPOSE: The usage of barbed sutures is increasingly being reported in the field of laparoscopic surgery. However, there have been reports of suture-related complications such as small bowel obstruction or anastomosis stricture. We present our experience of hepaticojejunostomy (HJ) using V-loc, during laparoscopic cyst excision for choledochal cyst. METHODS: At our center, from August 2014 to January 2015, 4 patients were treated for choledochal cyst. Laparoscopic cyst excision with Roux-en-Y HJ was performed, and HJ was performed with intracorporeal suturing using unidirectional barbed sutures...
May 20, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ji Wool Ko, Sung Hoon Choi, Sung Won Kwon, Kwang Hyun Ko
BACKGROUND: Complete removal of the dilated biliary tree is regarded as inevitable in choledochal cysts due to its malignant potential. However, technical difficulty and the high risk of postoperative complications as well as the various presentations of the disease make the surgical options for type IV-A cysts challenging and controversial. We report the first case of a type IV-A choledochal cyst treated using a robot-assisted approach. PATIENT AND METHODS: A 41-year-old healthy female was admitted with intrahepatic and extrahepatic cysts incidentally found on routine checkup...
April 29, 2016: Surgical Endoscopy
Olusegun Isaac Alatise, Olatunbosun Ayokunle Oke, Abdulrasheed Kayode Adesunkanmi, Olaejinrin O Olaofe, Christianah Mopelola Asaleye
Choledochal cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of gallbladder carcinoma coexisting with a choledochal cyst in a Nigerian patient. Clinical records of the patient including preoperative evaluation, intraoperative findings, and postoperative care were reviewed. A 38-year-old woman presented with the recurrent right upper abdominal pain of 3 years duration associated with progressive weight loss, anorexia, recurrent vomiting, as well as, low-grade fever with chills and rigors...
January 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
Hector Silva-Baez, Pedro Coello-Ramírez, Eddy Mizraím Ixtabalán-Escalante, Eduardo Sotelo-Anaya, Mariana Gallo-Morales, Eduardo Cordero-Estrada, Victor Hugo Sainz-Escarrega, César Felipe Ploneda-Valencia
BACKGROUND: Choledochal cyst (CC) is a rare congenital anomaly of the bile duct that approximately 75% of the patients are diagnosed in childhood. Without a standardized surgical procedure for the biliary reconstruction, we present our experience over the last 15 years and show the differences between the biliary reconstructions techniques in our population. METHODS: We did a retrospective hospital archive search for patients admitted to the pediatric surgery department with the diagnosis of a choledochal cyst from January 2000 to June 2015...
February 2016: Annals of Medicine and Surgery
Hasan Özkan Gezer, Pelin Oğuzkurt, Abdulkerim Temiz, Emine İnce, Semire Serin Ezer, Akgün Hiçsönmez
BACKGROUND/AIMS: Choledochal cysts (CCs) are rare abnormalities of the biliary tract. Presenting our clinical experience with CCs herein, we aimed to identify if intrahepatic ductal dilatation indicates true intrahepatic biliary duct disease. MATERIALS AND METHODS: We retrospectively reviewed all cases of CCs in children diagnosed at a single center (Başkent University Fac-ulty of Medicine, Department of Pediatric Surgery) institution from 2005 to 2015. RESULTS: Of 18 patients with CCs, 7 were males (39%)...
January 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Baochun Lu, Zhihong Shen, Jianhua Yu, Jianhui Yang, Haijun Tang, Hongli Ma
Choledochal cyst is prevalent in female than male. Diagnosis and management of choledochal cyst is important in clinical practice, or else, patients may develop cholangiocarcinoma. Currently, complete resection is the standard method for the treatment of choledochal cyst. However, traditional open surgery is usually needed in these procedures, which may induce postoperative injuries. In this case, we present our experiences for the management of choledochal cyst through radical removal combined with Roux-en-Y anastomosis under laparoscope...
2015: International Journal of Clinical and Experimental Medicine
Neel Aggerwal, Prema Menon, Katragadda Lakshmi Narasimha Rao, Kushaljit S Sodhi, Nandita Kakkar
AIMS: The aim was to compare biliary amylase, common channel, and gall bladder/liver histopathology between spherical and fusiform choledochal cysts. MATERIALS AND METHODS: Children undergoing cyst excision with Roux-en-Y hepatico-jejunostomy over a 17 months period were prospectively studied. The common channel was assessed by three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP). RESULTS: Among 22 patients (spherical = 10, fusiform = 12), there was a higher incidence of spherical cysts in infants (5/7-71...
July 2015: Journal of Indian Association of Pediatric Surgeons
Seung Eun Lee, Yoo Shin Choi, Mi Kyung Kim, Hyoung-Chul Oh, Jae Hyuk Do
Ovarian metastases represent about 3-5% of all ovarian malignancies. Most of these tumors originate in the digestive tract and cholangiocarcinoma rarely involves the ovary. A 60-year-old woman was admitted for the investigation of abdominal distension that had lasted 1 week. One and a half years prior, the patient had undergone choledochal cyst excision, Roux-en Y hepaticojejunostomy and cholecystectomy. Computed tomography scans of the abdomen revealed a papillary mass in the remnant distal common bile duct and enlargement of both ovaries with a huge amount of ascites...
May 2015: Korean Journal of Hepato-biliary-pancreatic Surgery
Zakaria Habib, Mila Kolar
BACKGROUND: Although Roux-en-Y hepaticojejunostomy is considered the gold standard of biliary reconstruction after excision of a choledochal cyst, there is increasing popularity of hepaticoduodenostomy, as it is easier to perform laparoscopically and provides physiologic bile drainage into the duodenum. Our animal research study had the goal to develop and test a new biliary reconstructive procedure (the duodenotubular flap [DTF]), with the advantages of providing physiological bile flow into the duodenum, technical simplicity of duodenal conduit construction, and ability of endoscopic assessment in case of complications...
July 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hong-Tian Xia, Tao Yang, Bin Liang, Jian-Ping Zeng, Jia-Hong Dong
BACKGROUND: The purpose of this study is to report our experience with the treatment of remnant intrapancreatic choledochal cysts (CCs) in adults. METHODS: We reviewed retrospectively the records of patients with intrapancreatic remnant CCs who underwent reoperation by our surgical team from January 2000 to December 2012. Postoperative complications, surgical outcomes, and rate of malignancy were noted. RESULTS: A total of 41 patients were included: 35 without malignant transformation after the primary operation and 6 with malignant transformation...
February 2016: Surgery
A Yamataka, G J Lane, H Koga, J Cazares, H Nakamura
Minimally invasive surgery in children has evolved to the extent that complex procedures can be performed with safety, with comparable outcomes to open surgery and with the advantages of minimal scarring and less pain. In this article, we describe the latest laparoscopic techniques used at Juntendo University Hospital in Japan, for treating conditions affecting the porta hepatis, focusing on biliary atresia and choledochal cysts. We also summarise our postoperative management protocols and discuss preliminary outcomes...
November 2014: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
J J Atkinson, M Davenport
Choledochal malformations (some of which are choledochal cysts) may be characterised as an abnormal dilatation of the biliary tract in the absence of acute obstruction. Most appear to be of congenital origin, probably related to distal bile duct stenosis, and almost 15% can now be detected antenatally. Excision and biliary reconstruction using a Roux loop as an open operation is still the standard to compare against, although laparoscopic reconstruction is increasingly reported. This article discusses recent advances in the understanding of choledochal malformation aetiology and classification, together with the role of newer modalites of surgical treatment such as laparoscopic excision and biliary reconstruction...
November 2014: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Osman Faruk Şenyüz, Fatih Gülşen, Okan Gökhan, Şenol Emre, Egemen Eroğlu
The development of intra- and extrahepatic bile duct stones has been reported as one of the most serious complications after choledochal cyst excision with biliary-enteric reconstruction through Roux-en-Y hepaticojejunostomy (HJ). Here, we report our experience with extracorporeal shock wave lithotripsy (ESWL) in a case of giant intrahepatic stones developing after choledochal cyst surgery. ESWL is an excellent therapeutic modality for large intrahepatic biliary calculi, and after dilating the HJ anastomosis percutaneously, it can be offered as first-line therapy to these patients...
May 2015: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Ross Mazo, Alejandro R Ruiz-Elizalde, John A Chabot, Robert A Cowles
BACKGROUND/AIMS: Choledochal cyst (CDC) is a rare congenital cystic dilatation of the biliary system that can affect children and adults. Standard treatment for CDC includes surgical excision of the cystic bile duct with restoration of bilioenteric continuity by Roux-en-Y hepaticojejunostomy. In rare situations, however, surgical excision of a CDC may require pancreaticoduodenectomy (PD). The goal of this study was to identify instances where a PD may be deemed necessary. METHODOLOGY: We retrospectively reviewed the medical records of all patients treated for CDC at our institution from January 1988 through December 2011...
January 2015: Hepato-gastroenterology
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