Comparison of Therapeutic Effects of Laparoscopic Versus Open Operation in Treatment for Adult Congenital Cholangiectasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yuan , ZHOU Yong , YAO Xu , LIU Lei , LIU Jingang

Department of General Surgery， Affiliated Shengjing Hospital of China Medical University， Shenyang 110004， Liaoning Province， China;

Corresponding author：

Keywords：

Laparoscope; Congenital cholangiectasis cyst; Operation; Adult

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Objective 　To explore the feasibility and safety of laparoscopic cyst resection and Roux-en-Y hepatojejunostomy in treatment for adult congenital cholangiectasis and to compare the therapeutic effects of laparoscopic procedure with conventional open procedure.
Methods 　The clinical data of 33 adult patients with congenital cholangiectasis from May 2008 to September 2011 in the department of general surgery of Shengjing Hospital of China Medical University were retrospectively analyzed. Fourteen patients received laparoscopic procedure （laparoscopic group），whereas the other 19 patients received conventional open procedure （conventional group）.
Results 　All the operations were carried out successfully through laparoscopic procedure. The mean time of operation in the laparoscopic group was significantly longer than that in the conventional group （195min versus 130min，P＜0.01）. The average intraoperative blood loss in the laparoscopic group was significantly less than that in the conventional group （80ml versus 270ml，P＜0.01）. In contrast，the mean time of bowel peristalsis recovery and postoperative hospital stay in the laparoscopic group were significantly shorter than those in the conventional group （time of bowel motion recovery：76h versus 104 h，P＜0.01；hospital stay：6.1 d versus 9.6 d，P＜0.01）. There were no differences in the early complications between two groups （P＞0.05）.
Conclusions 　Totally laparoscopic treatment for congenital cholangiectasis in adult is feasible and safe. It is worth to be generally applied because of its minimal invasion and fast postoperative recovery.

Citation： LIU Yuan,ZHOU Yong,YAO Xu,LIU Lei,LIU Jingang,.. Comparison of Therapeutic Effects of Laparoscopic Versus Open Operation in Treatment for Adult Congenital Cholangiectasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(9): 947-950. doi: Copy

1.	Saing H， Han H， Chan KL， et al. Early and late results of excision of choledochal cysts[J]. J Pediatr Surg， 1997， 32(11)：1563-1566.
2.	Edil BH， Cameron JL， Reddy S， et al. Choledochal cyst disease in children and adults：a 30-year single-institution experience[J]. J Am Coll Surg， 2008， 206(5)：1000-1005.
3.	Visser BC， Suh I， Way LW， et al. Congenital choledochal cysts in adults[J]. Arch Surg， 2004， 139(8)：855-860.
4.	熊先泽，程南生，彭其芳，等. 成人先天性胆总管囊肿的诊断及治疗[J]. 中国普外基础与临床杂志， 2005， 12(4)：353-354.
5.	刘崇清，王小非，田云鸿，等. 成人先天性胆总管囊肿38例诊治分析[J]. 中国普外基础与临床杂志， 2012， 19(1)：102-104.
6.	Tan HL， Shankar KR， Ford WD. Laparoscopic resection of type Ⅰ choledochal cyst[J]. Surg Endosc， 2003， 17(9)：1495.
7.	Farello GA， Cerofolini A， Rebonato M， et al. Congenital choledochal cyst：video-guided laparoscopic treatment[J]. Surg Laparosc Endosc， 1995， 5(5)：354-358.
8.	李龙，余奇志，刘刚，等. 经腹腔镜行先天性胆总管囊肿切除肝管空肠Roux-Y吻合术的探讨[J]. 临床小儿外科杂志， 2002， 1(1)：54-56.
9.	李龙，余奇志，刘刚，等. 经腹腔镜行先天性胆总管囊肿根治切除术的技术要点[J]. 中华普通外科杂志， 2002， 17(8)：473-475.
10.	李龙，付京波，余奇志，等. 腹腔镜行巨大先天性胆总管囊肿切除术的探讨[J]. 临床小儿外科杂志， 2003， 2(4)：250-252.
11.	陈兰萍，任红霞，李龙，等. 腹腔镜下治疗6月内幼婴先天性胆总管囊肿的探讨[J]. 山西医科大学学报， 2005， 36(1)：103-104.
12.	侯文英，李龙，刘树立，等. 腹腔镜肝管空肠Roux-en-Y吻合术治疗52例3岁以内婴幼儿先天性胆总管囊肿[J]. 中国微创外科杂志， 2008， 8(9)：772-774.
13.	Ure BM， Nustede R， Becker H. Laparoscopic resection of congenital choledochal cyst， hepaticojejunostomy， and externally made Roux-en-Y anastomosis[J]. J Pediatr Surg， 2005， 40(4)：728-730.
14.	Jang JY， Kim SW， Han HS， et al. Totally laparoscopic management of choledochal cysts using a four-hole method[J]. Surg Endosc， 2006， 20(11)：1762-1765.
15.	Liuming H， Hongwu Z， Gang L， et al. The effect of laparoscopic excision vs. open excision in children with choledochal cyst：a midterm follow-up study[J]. J Pediatr Surg， 2011， 46(4)：662-665.
16.	刘雪来，李龙，张军，等. 经腹腔镜行先天性胆总管囊肿根治术并发症的探讨[J]. 中国微创外科杂志， 2007， 7(5)：436-438.
17.	沈威，段雨，毛盛勋. 胆总管囊肿切除术治疗先天性胆总管囊肿的术式比较[J]. 中国普通外科杂志， 2009， 18(12)：1288-1290.
18.	龙涤，方富义. 先天性胆总管囊肿的腹腔镜治疗进展[J]. 医学综述， 2009， 15(24)：3759-3761.
19.	李索林，李英超，耿娜，等. 腹腔镜胆总管囊肿根治切除、肝管空肠吻合术[J]. 腹腔镜外科杂志， 2007， 12(2)：147-149.
20.	Santore MT， Deans KJ， Behar BJ， et al. Laparoscopic hepaticoduodenostomy versus open hepaticoduodenostomy for reconstruction after resection of choledochal cyst[J]. J Laparoendosc Adv Surg Tech A， 2011， 21(4)：375-378.
21.	Gander JW， Cowles RA， Gross ER， et al. Laparoscopic excision of choledochal cysts with total intracorporeal reconstruction[J]. J Laparoendosc Adv Surg Tech A， 2010， 20(10)：877-881.

1. Saing H， Han H， Chan KL， et al. Early and late results of excision of choledochal cysts[J]. J Pediatr Surg， 1997， 32(11)：1563-1566.
2. Edil BH， Cameron JL， Reddy S， et al. Choledochal cyst disease in children and adults：a 30-year single-institution experience[J]. J Am Coll Surg， 2008， 206(5)：1000-1005.
3. Visser BC， Suh I， Way LW， et al. Congenital choledochal cysts in adults[J]. Arch Surg， 2004， 139(8)：855-860.
4. 熊先泽，程南生，彭其芳，等. 成人先天性胆总管囊肿的诊断及治疗[J]. 中国普外基础与临床杂志， 2005， 12(4)：353-354.
5. 刘崇清，王小非，田云鸿，等. 成人先天性胆总管囊肿38例诊治分析[J]. 中国普外基础与临床杂志， 2012， 19(1)：102-104.
6. Tan HL， Shankar KR， Ford WD. Laparoscopic resection of type Ⅰ choledochal cyst[J]. Surg Endosc， 2003， 17(9)：1495.
7. Farello GA， Cerofolini A， Rebonato M， et al. Congenital choledochal cyst：video-guided laparoscopic treatment[J]. Surg Laparosc Endosc， 1995， 5(5)：354-358.
8. 李龙，余奇志，刘刚，等. 经腹腔镜行先天性胆总管囊肿切除肝管空肠Roux-Y吻合术的探讨[J]. 临床小儿外科杂志， 2002， 1(1)：54-56.
9. 李龙，余奇志，刘刚，等. 经腹腔镜行先天性胆总管囊肿根治切除术的技术要点[J]. 中华普通外科杂志， 2002， 17(8)：473-475.
10. 李龙，付京波，余奇志，等. 腹腔镜行巨大先天性胆总管囊肿切除术的探讨[J]. 临床小儿外科杂志， 2003， 2(4)：250-252.
11. 陈兰萍，任红霞，李龙，等. 腹腔镜下治疗6月内幼婴先天性胆总管囊肿的探讨[J]. 山西医科大学学报， 2005， 36(1)：103-104.
12. 侯文英，李龙，刘树立，等. 腹腔镜肝管空肠Roux-en-Y吻合术治疗52例3岁以内婴幼儿先天性胆总管囊肿[J]. 中国微创外科杂志， 2008， 8(9)：772-774.
13. Ure BM， Nustede R， Becker H. Laparoscopic resection of congenital choledochal cyst， hepaticojejunostomy， and externally made Roux-en-Y anastomosis[J]. J Pediatr Surg， 2005， 40(4)：728-730.
14. Jang JY， Kim SW， Han HS， et al. Totally laparoscopic management of choledochal cysts using a four-hole method[J]. Surg Endosc， 2006， 20(11)：1762-1765.
15. Liuming H， Hongwu Z， Gang L， et al. The effect of laparoscopic excision vs. open excision in children with choledochal cyst：a midterm follow-up study[J]. J Pediatr Surg， 2011， 46(4)：662-665.
16. 刘雪来，李龙，张军，等. 经腹腔镜行先天性胆总管囊肿根治术并发症的探讨[J]. 中国微创外科杂志， 2007， 7(5)：436-438.
17. 沈威，段雨，毛盛勋. 胆总管囊肿切除术治疗先天性胆总管囊肿的术式比较[J]. 中国普通外科杂志， 2009， 18(12)：1288-1290.
18. 龙涤，方富义. 先天性胆总管囊肿的腹腔镜治疗进展[J]. 医学综述， 2009， 15(24)：3759-3761.
19. 李索林，李英超，耿娜，等. 腹腔镜胆总管囊肿根治切除、肝管空肠吻合术[J]. 腹腔镜外科杂志， 2007， 12(2)：147-149.
20. Santore MT， Deans KJ， Behar BJ， et al. Laparoscopic hepaticoduodenostomy versus open hepaticoduodenostomy for reconstruction after resection of choledochal cyst[J]. J Laparoendosc Adv Surg Tech A， 2011， 21(4)：375-378.
21. Gander JW， Cowles RA， Gross ER， et al. Laparoscopic excision of choledochal cysts with total intracorporeal reconstruction[J]. J Laparoendosc Adv Surg Tech A， 2010， 20(10)：877-881.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of Therapeutic Effects of Laparoscopic Versus Open Operation in Treatment for Adult Congenital Cholangiectasis

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