Hepaticoduodenostomy versus hepaticojejunostomy after resection of choledochal cyst: A systematic review and meta-analysis

Narayanan, Sarath Kumar; Chen, Yong; Narasimhan, Kannan Laksmi; Cohen, Richard. D.

doi:10.1016/j.jpedsurg.2013.07.020

Cited by 102 publications

(81 citation statements)

References 14 publications

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“…A recent meta-analysis included total of 679 patients comparing HD and Roux-en-Y HJ reconstruction suggested that the HD was comparable to conventional HJ in most postoperative outcomes including bile leak, postoperative cholangitis, anastomotic stricture, adhesive intestinal obstruction and reoperation rates [20]. The only significant differences between the HJ and HD groups were the higher rate of duodenogastric reflux and associated bilious gastritis, as well as shorter operative time and hospital stay in the HD group [12,13,20]. However, generalisation of this metaanalysis is inappropriate since the longest follow-up in the included studies is only 7 years.…”

Section: Discussionmentioning

confidence: 99%

Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience

et al. 2014

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“…[20][21][22][23] A recent meta-analysis study by Narayanan et al support the procedure of cyst excision and RYHJ. 24 In our experience, we have done HD in five cases, in two of them developed post-operative minor bile leak in drain that improve on conservative measures no redo surgical intervention required. On follow up of these cases up to 2½ years, none of them developed complications of biliary gastritis, cholangitis or anastomotic site stricture.…”

Section: Discussionmentioning

confidence: 92%

Congenital choledochal malformations in children: management strategies

2017

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Background: A Congenital Choledochal Malformations (CCM) is common congenital defect of biliary tree in Asian subcontinent. Presentations of CCM are vague from asymptomatic to life threatening cholangitis or pancreatitis. Complete cyst excision and bilioenteric anastomosis is now accepted surgical treatment.Methods: This is a retrospective study of five years duration. In this study the clinical presentation, haematological, biochemical and radiological findings, operative procedure and outcome were studied from case records.Results: Total of 20 patients were studied, with clinical presentation of recurrent abdominal pain in eight cases, previous history of cholangitis in five cases, acute cholangitis two cases, biliary peritonitis in four cases and previous history of pancreatitis in one case. In 13 cases Roux-en-Y hepaticojejunostomy (RYHJ) and in 4 cases hepaticoduodenostomy (HD) done after cyst excision. One case of type II CCM managed with only cyst excision, in two cases Lilly’s procedure, one case requires temporary external drainage and in two cases temporary internal drainage done in view on cholangitis and jaundice.Conclusions: However, the definitive treatment of CCM is complete cyst excision and bilioenteric anastomosis, though lot of other temporary majors are also required at different stages of disease.

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“…Hepatoduodenostomy is more physiologic and technically easy; however, surgeons often prefer a Roux-en-Y reconstruction for its safety. Narayanan and colleagues [13] conducted a meta-analysis, which showed that it is comparable in most postoperative outcomes between the two procedures; nevertheless, hepatoduodenostomy demonstrated higher postoperative reflux/gastritis than hepatojejunostomy but a shorter hospital stay. Laparoscopic hepatojejunostomy for children with choledochal cysts has been gaining popularity recently.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Single-Incision and Conventional Laparoscopic Cyst Excision and Roux-en-Y Hepaticojejunostomy for Children with Choledochal Cysts

Tang

2015

Indian J Surg

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The purpose of this study was to elucidate the potential benefits of single-incision laparoscopic Roux-en-Y hepaticojejunostomy comparing the conventional laparoscopic procedures. From January 2013 to July 2013, 17 consecutive children with choledochal cysts received single-incision laparoscopic Roux-en-Y hepaticojejunostomies by a single surgeon at our institution. Seventeen standard laparoscopic hepaticojejunostomies of consecutive children with choledochal cysts from July 2012 to December 2012 were employed as control. Demographic and perioperative information was identified retrospectively using clinic and hospital records including gender, age, total operating time, estimated blood loss, time to oral intake, drainage removal time, postoperative complications, and postoperative hospital stay. One patient was converted to open surgery and another 8-year-old boy conversed to conventional four-port laparoscopic procedure. There were no significant differences between the conventional laparoscopic group and the single-incision laparoscopic group with regard to preoperative variables including age (P=0.697) and sex distribution (P=1.000). For mean operative time (209.9±7.5 vs 204.1±6.9 min, P=0.951), estimated blood loss (10.7±1.1 vs 13.4±1.7 ml, P=0.103), time to oral intake (3.73± 0.21 vs 3.77±0.20 days, P =0.889), drainage removal time (4.20±0.45 vs 4.06±0.23 days, P= 0.067), and postoperative hospital stay (7.60±0.25 vs 7.41± 0.21 days, P=0.627), the differences were also nonsignificant. Nevertheless, this technique demonstrated improved cosmetic outcomes comparing with the conventional laparoscopic group. The results showed better cosmetic results and comparable postoperative outcomes. However, well-designed prospective studies are warranted to better address this issue.

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Hepaticoduodenostomy versus hepaticojejunostomy after resection of choledochal cyst: A systematic review and meta-analysis

Cited by 102 publications

References 14 publications

Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience

Biliary-enteric reconstruction with hepaticoduodenostomy following laparoscopic excision of choledochal cyst is associated with better postoperative outcomes: a single-centre experience

Congenital choledochal malformations in children: management strategies

Comparison of Single-Incision and Conventional Laparoscopic Cyst Excision and Roux-en-Y Hepaticojejunostomy for Children with Choledochal Cysts

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