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 ORIGINAL ARTICLE
Year : 2017  |  Volume : 13  |  Issue : 4  |  Page : 261-264

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


1 Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
2 Department of Anaesthesia, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India

Correspondence Address:
Hirdaya Hulas Nag
Room No. 220, Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi - 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_159_16

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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.






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