Laparoscopic excision of a choledochal cyst in 82 consecutive patients.

Jang, Jin-Young; Yoon, Yoo-Seok; Kang, Mee Joo; Kwon, Wooil; Park, Jae Woo; Chang, Ye Rim; Ahn, Young-Joon; Cho, Jai Young; Han, Ho-Seong; Kim, Sun-Whe

INTRODUCTION Despite it being a benign disease, a choledochal cyst must be removed with the gallbladder (GB) due to the risk of cancer in the biliary tract. Most patients are young females or children, all of whom express strong interest in the cosmetic results in addition to the complete resolution of their medical problems. Here, we introduce a laparoscopic management technique for a choledochal cyst. METHODS Between 2003 and 2011, we performed a laparoscopic choledochal cyst excision procedure on 82 patients using a four-hole method. There were three open-conversion cases, one case involving robotic surgery, and one case involving combined laparoscopic liver resection because the cyst had affected the liver. Excision of the cyst and anastomosis were performed laparoscopically. We will present our method with a video. RESULTS The mean operation time was 230 min. The estimated blood loss was 197 ml. The average hospital stay was 8.6 days. The most common complications were minor bile leakage (7 %) and fluid collection (2.5 %), both of which were managed conservatively. CONCLUSIONS Laparoscopic management can be a treatment of choice for the most instances of choledochal cyst considering its good cosmetic results and its feasible level of operative safety.