Single-incision laparoscopic Roux-en-Y hepaticojejunostomy using conventional instruments for children with choledochal cysts.

BACKGROUND

Single-incision laparoscopy has recently become popular in pediatric surgery. Yet there has been no report on its application in the management of choledochal cysts (CDC). The current series is the first study to evaluate the safety and efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) for CDC in children.

METHODS

We reviewed 19 children who underwent SILH between April and June 2011. Early postoperative and follow-up results were compared with our historical controls.

RESULTS

The median follow-up period was 3 months. Two procedures were converted to the conventional four-port laparoscopic hepaticojejunostomies. SILH was successfully completed in 17 patients (median age: 3.00 years; F/M: 12/5). Early in the series, one patient developed bile leak, which stopped spontaneously after 10 days of drainage. The mean operative time of the SILH group did not differ from that of our conventional laparoscopic hepaticojejunostomy (CLH) controls (3.06 vs. 3.04 h, P = 0.909). The average postoperative hospital stay, time to full feed, and duration of drainage in the SILH group were comparable to our historical controls of CLH (P = 0.056, 0.472, 0.619, respectively).

CONCLUSIONS

In experienced hands, SILH is safe and its short-term results are comparable to CLH. It potentially provides a viable surgical alternative for CDC.