scholarly journals Laparoscopic treatment of congenital choledochal cyst and hepaticojejunostomy with extracorporeal Roux-en-Y anastomosis: technical aspects and early experience with three cases

2016 ◽  
Vol 38 (2) ◽  
Author(s):  
Mario Lima ◽  
Tommaso Gargano ◽  
Giovanni Ruggeri ◽  
Francesca Destro ◽  
Michela Maffi
Keyword(s):  
Choledochal Cyst ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Early Experience ◽  
Cyst Excision ◽  
Intrahepatic Bile Ducts ◽  
First Case ◽  
Laparoscopic Excision ◽  
Extracorporeal Anastomosis ◽  
Laparoscopic Removal

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. We performed the laparoscopic removal of the cyst and gallbladder, videoassisted preparation of the Roux-en-Y loop and laparoscopic hepaticjejunostomy. No post-operative complications occurred. Laparoscopic excision of CDCs has been supposed to give better observation, a better cosmetic result, potentially less postoperative pain, and a shorter recovery. The main argument for performing an extracorporeal anastomosis is that it decreases the operative time. We recommend caution to prevent injury to the pancreatic duct and biliary structures during dissection and anastomosis. Lifelong surveillance is mandatory, even after resection of the choledochal cyst.

Laparoscopic management of type VI choledochal cyst with common bile duct stone: report of a case and review of literature

2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Incidental Finding ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Type I ◽  
Laparoscopic Management ◽  
Cyst Excision

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.

scholarly journals Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: a single-institution prospective cohort study

2019 ◽  
Vol 6 (8) ◽  
pp. 2860
Author(s):  
Nguyen Thanh Xuan ◽  
Ho Huu Thien ◽  
Phan Hai Thanh ◽  
Pham Anh Vu ◽  
Nguyen Huu Son ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Operative Time ◽  
Bile Leakage ◽  
Short Term ◽  
Cyst Excision ◽  
Drain Removal ◽  
Laparoscopic Excision ◽  
The Mean ◽  
Mean Time ◽  
Time To Drain

Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases. 

scholarly journals A Feasible Technique in Laparoscopic Excision for Juvenile Cystic Adenomyosis: A Case Report, Literature Review, and Surgical Video

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 284-292
Author(s):  
Masafumi Katakura ◽  
Yukiko Katagiri ◽  
Kuniaki Ota ◽  
Takafumi Mukai ◽  
Kentaro Nakaoka ◽  
...  
Keyword(s):  
Literature Review ◽  
Laparoscopic Approach ◽  
Blunt Dissection ◽  
Pelvic Magnetic Resonance Imaging ◽  
Cyst Excision ◽  
Surgical Video ◽  
Contrast Enhanced ◽  
First Choice ◽  
Laparoscopic Excision ◽  
Choice Of Treatment

Background: Juvenile cystic adenomyosis (JCA) is a rare uterine lesion. We present the case of a young woman who was diagnosed with JCA and subsequently managed with laparoscopic cyst removal with sharp and blunt dissection. Moreover, we provide a literature review and a surgical video. Case: A 22-year-old nulliparous woman presented with severe dysmenorrhea and was assessed using contrast-enhanced abdominal computed tomography, transvaginal ultrasonography and pelvic magnetic resonance imaging, and diagnosed with a cystic lesion on the left side of the myometrium. She underwent laparoscopic cyst excision and uterine reconstruction. Histology was suggestive of JCA. The dysmenorrhea resolved postoperatively. Conclusion: Surgical resection is the first choice of treatment for cystic adenomyosis, and a laparoscopic approach using scissor forceps is effective.

OUTCOME OF THE LAPAROSCOPIC CHOLEDOCHAL CYST EXCISION

2017 ◽  
pp. 239-244
Author(s):  
Thanh Xuan Nguyen ◽  
Dinh khanh Le ◽  
Huu Thien Ho
Keyword(s):  
Bile Duct ◽  
Choledochal Cyst ◽  
Postoperative Treatment ◽  
High Tech ◽  
Type I ◽  
Duct Cyst ◽  
Drain Pipe ◽  
Cyst Excision ◽  
Bile Duct Cyst ◽  
Laparoscopic Excision

Objectives: To study the clinical and subclinical characteristics, and the treatment results of the laparoscopic choledochal cyst excision. Subjects and Methods: patients with bile duct cyst were diagnosed and treated by laparoscopic excision at the Hue Central Hospital from 6/2013 to 9/2017. Result: The common bile duct cyst was type I with highest ratio (90.77%), in which type Ic occupied the rate was 53.84%. The most common clinical manifestation was abdominal pain which occupied 87.69% of cases. The average time of opreation was 197.58 ± 46.57. Drain pipe was removed within 1-4 days after surgery. The average time of postoperative treatment was 8.7 ± 3.8 days. The rate of early complications after surgery was 3.07%. The rate of postoperative complications was 1.54%. Conclusion: Laparoscopic treatment of choledochal cyst is safe, feasible and efficient in medical high-tech center Key words: laparoscopic, bile duct cyst

Early experience with laparoscopic excision of choledochal cyst in 41 children

2012 ◽  
Vol 47 (12) ◽  
pp. 2175-2178 ◽  
Author(s):  
Bin Wang ◽  
Qi Feng ◽  
Jian-xiong Mao ◽  
Lei Liu ◽  
Kenneth K.Y. Wong
Keyword(s):  
Choledochal Cyst ◽  
Early Experience ◽  
Laparoscopic Excision

scholarly journals Early experience of laparoscopic choledochal cyst excision in children

2013 ◽  
Vol 85 (5) ◽  
pp. 225 ◽  
Author(s):  
Joon-Hyop Lee ◽  
Soo-Hong Kim ◽  
Hyun-Young Kim ◽  
Young Hoon Choi ◽  
Sung-Eun Jung ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Early Experience ◽  
Cyst Excision

scholarly journals Symptomatic cystic seminal vesicle: a laparoscopic approach for effective treatment

2013 ◽  
Vol 3 (6) ◽  
pp. 81 ◽  
Author(s):  
Anmar Nassir
Keyword(s):  
Renal Agenesis ◽  
Iliac Fossa ◽  
Preoperative Evaluation ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Uneventful Recovery ◽  
The Third ◽  
Laparoscopic Excision ◽  
Right Iliac Fossa Pain

This case report highlights a symptomatic cystic seminal vesiclelesion, treated laparoscopically. A young adult male known tohave congenital right renal agenesis presented with a history ofrecurrent right iliac fossa pain, as well as deep pelvic discomfort.The preoperative evaluation revealed a 7 x 4.5 x 4 cm cystic seminalvesicle mass. After discovery of the mass, the patient underwenta transperitoneal laparoscopic excision of the lesion. Thepatient was discharged on the third postoperative day and hadan uneventful recovery. There were no complications noted duringa routine follow-up. The laparoscopic approach was shownto be effective in the management of this rare condition.

scholarly journals Laparoscopic Excision Versus Open Excision for the Treatment of Choledochal Cysts: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 100 (1) ◽  
pp. 115-122 ◽  
Author(s):  
Chen Zhen ◽  
Zhang Xia ◽  
Li Long ◽  
Ma Lishuang ◽  
Yu Pu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Choledochal Cyst ◽  
Meta Analysis ◽  
Bile Leak ◽  
Cochrane Library ◽  
Cyst Excision ◽  
Significant Difference ◽  
Laparoscopic Excision ◽  
Open Excision

Abstract In 1723, Vater first described choledochal cyst and in 1977, Todani et al classified this disease. For many years, open excision (OP) as the standard procedure made a great impact in the treatment of choledochal cyst. Since 1995, when Farello et al first reported laparoscopic choledochal cyst excision, laparoscopic excision (LA) has been used worldwide. However, its safety remains a major concern. The aim of this meta-analysis was to compare OP with LA in treating choledochal cyst and then to determine whether LA is safe and valid. The design of this study involved systematic review and meta-analysis. Data sources were Medline, Ovid, Elsevier, Google Scholar, Embase, and Cochrane library. The study selection entailed comparative cohort studies. For data extraction, 2 investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc. For the results, 7 comparative cohort studies about the effectiveness of LA compared with OP were performed meta-analysis. The results showed that although the LA group had a longer operative time (MD = 56.57; 95% CI = 32.20–80.93; P < 0.00001), LA had a shorter duration of hospital stay (MD = −1.93; 95% CI = −2.51 to −1.36; P < 0.00001), and recovery of bowel function (MD = −0.94; 95% CI = −1.33 to −0.55; P < 0.00001). Meta-analysis found no significant difference between most of the 2 groups: bile leak (RR = 0.60; 95% CI = 0.29–1.24; P = 0.17), abdominal bleeding (RR = 0.33; 95% CI = 0.01–8.98; P = 0.51), pancreatitis (RR = 0.26, 95% CI = 0.06–1.03; P = 0.06), total postoperative complications (RR = 1.04; 95% CI = 0.66–1.62; P = 0.88). The LA group had significant lower rates in intraoperative blood transfusion (RR = 0.20; 95% CI = 0.11–0.38; P < 0.00001), and adhesive intestinal obstruction (RR = 0.17, 95% CI = 0.04–0.77; P = 0.02). In conclusion, compared with open excision, laparoscopic excision is a safe, valid, and feasible alternative to open excision.

scholarly journals Choledochal cyst: Early experience by laparoscopic approach

2016 ◽  
Vol 11 ◽  
pp. 4-6 ◽  
Author(s):  
M. Sica ◽  
F. Molinaro ◽  
R. Angotti ◽  
E. Bindi ◽  
E. Brandigi ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Laparoscopic Approach ◽  
Early Experience

Severe Antithrombin III Deficiency in an Infant Associated with Multiple Arterial and Venous Thromboses

1976 ◽  
Vol 36 (03) ◽  
pp. 495-502 ◽  
Author(s):  
Geoffrey Mendelsohn ◽  
Edward D. Gomperts ◽  
Dennis Gurwitz
Keyword(s):  
Antithrombin Iii ◽  
Adult Life ◽  
Rare Condition ◽  
Male Infant ◽  
Liver Cells ◽  
Liver Pathology ◽  
Fixed Tissue ◽  
Formalin Fixed Tissue ◽  
First Case ◽  
At Iii

SummaryInherited antithrombin III (AT-II, heparin cofactor) deficiency is a rare condition, presenting with thrombotic disease in adult life. This paper reports an 8 months old South African Black male infant with multiple large vessel venous and arterial thromboses, and E. coli septicaemia. This was associated with an extremely low plasma AT-II level. Micronodular cirrhosis and intracytoplasmic hyaline globules in the liver cells were present. These globules were eosinophilic, and PAS-positive after diastase. They measured approximately 5 μ to 30 μ in diameter, occurred singly in the liver cells and were located mainly in the periportal areas. The histological findings in the liver are similar to those observed in α1-antitrypsin (AAT) deficiency in which the intracytoplasmic globules represent accumulation of altered AAT. Immunochemical studies carried out on formalin fixed tissue failed to detect cross reaction material with anti-α1 antitrypsin or anti-AT III antiserum. This is the first case report of AT-III deficiency presenting in infancy. It is also the first case associated with distinctive liver pathology.The available data presented are insufficient to distinguish between an inborn defect and acquired causes of the severely depressed AT-III plasma level and the distinctive liver pathology.

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