PurposeTo report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts.MethodsBetween January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6–145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis.ResultsThe average operation duration was 129.34 ± 23.50 min. The time until first flatus and resumption of oral diet were 26.51 ± 4.13 h and 5.47 ± 0.77 day, respectively. The mean postoperative hospital stay was 11.84 ± 2.58 day. Postoperative complications occurred in six patients: intestinal obstruction (1 patient), postoperative bleeding (1 patient), postoperative pancreatitis (1 patient), and bile leakage (3 patients). During a follow-up of 2–7 years, four cases of occasional abdominal pain were found. Contrast agent reflux was detected on upper gastrointestinal imaging in three children. All children had good nutrition.ConclusionThe modified biliary-enteric anastomosis is a safe, simple, and reliable technique. However, longer follow-up and a larger sample size are necessary to prove its efficacy in the treatment of congenital choledochal cysts.
BackgroundAlmost all hepatoblastomas are isolated to the liver. Hepatoblastoma arising from and limited to extrahepatic tissue is an extremely rare clinical entity.Case presentationHere we present a case of a 7-year-old Chinese boy of Han ethnicity with hepatoblastoma originating from the hepatogastric ligament. A complete resection was performed and the entire course was uneventful. He received six cycles of postoperative chemotherapy and had no signs of recurrence for 3 years after surgery.ConclusionsHepatoblastoma arising from extrahepatic tissue is extremely rare. A pedunculated hepatoblastoma is prone to hemorrhage and tumor metastasis. The best treatment for a long-term cure is complete resection of the primary tumor combined with chemotherapy.
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