Robotic versus laparoscopic surgery for choledochal cyst in children with aberrant hepatic ducts: A retrospective study

Xie, Xiaoyan; Li, Kewei; Xiang, Bo

doi:10.1016/j.asjsur.2022.11.006

Cited by 3 publications

(6 citation statements)

References 12 publications

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“…In contrast, Xiaolong et al. compared the results of laparoscopic and robot‐assisted surgery in patients with CBD with APHD and reported the safety and usefulness of robot‐assisted surgery 13 . In our institution, single‐hole hepaticojejunostomy for patients with CBD with APHD was performed in seven of eight cases.…”

Section: Discussionmentioning

confidence: 79%

“…12 In contrast, Xiaolong et al compared the results of laparoscopic and robot-assisted surgery in patients with CBD with APHD and reported the safety and usefulness of robot-assisted surgery. 13 In our institution, single-hole hepaticojejunostomy for patients with CBD with APHD was performed in seven of eight cases. However, we encountered one patient for whom single-hole anastomosis was difficult to perform because the APHD in the patient was relatively thin and fragile.…”

Section: Discussionmentioning

confidence: 98%

“…Recently, laparoscopic and robot-assisted laparoscopic surgeries for CBD have been introduced in several institutions. 9,12,13,24,25 Anatomical variations in the hepatic arteries have been classified by Hiatt. 15 A recent report from China showed no difference in the frequency of anatomical variations of the hepatic arteries based on Hiatt's classification in patients with CBD compared with the normal population 2,3,5 ; however, ARHA, which is excluded from Hiatt's classification and runs ventral to the CHD, has been reported to be more prevalent in patients with CBD (13%-33%) than in the normal population (10%-17%).…”

Section: Discussionmentioning

confidence: 99%

“…Radical surgery for CBD involves the complete resection of the dilated extrahepatic duct and a large hilar Roux‐en‐Y hepaticojejunostomy. Recently, laparoscopic and robot‐assisted laparoscopic surgeries for CBD have been introduced in several institutions 9,12,13,24,25 …”

Section: Discussionmentioning

confidence: 99%

“…The incidence of bile duct variations has also been demonstrated in many reports. [10][11][12][13][14] Among these, the most clinically significant variation is an aberrant posterior hepatic duct (APHD), which drains into the CHD or cystic duct separately. 10 It requires bile duct plasty for single-hole hepaticojejunostomy with a wide anastomosis.…”

mentioning

confidence: 99%

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Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Takada,

Uchida,

Hinoki

et al. 2023

J Hepato Biliary Pancreat

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PurposePreoperative comprehension of the anatomical variations of the hepatic artery and bile duct is essential for safe laparoscopic surgery for pancreaticobiliary maljunction (PBM). This study aimed to investigate the impact of anatomical variations of the hepatic artery and bile duct on surgical technique and postoperative complications.MethodsWe conducted a retrospective review of patients with PBM who underwent laparoscopic surgery at our institution between January 2014 and December 2022 to investigate anatomical variations in the hepatic artery and bile duct, surgical technique, and postoperative complications.ResultsWe included 112 patients with PBM, with a median age of 4 years (interquartile range, 0–55). Overall, 29 of 112 patients had an aberrant right hepatic artery (ARHA) running ventral to the common hepatic duct (CHD), and they underwent hepaticojejunostomy on the ventral side of the ARHA. Additionally, eight of 112 patients had an aberrant posterior hepatic duct (APHD), which was joined to the CHD in all but one case. The presence of APHD was associated with postoperative bile leak occurrence.ConclusionPerforming hepaticojejunostomy ventral to the ARHA is important to prevent complications. Furthermore, APHD may be a risk factor for postoperative bile leak and requires careful bile duct plasty.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Takada,

Uchida,

Hinoki

et al. 2023

J Hepato Biliary Pancreat

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Type I choledochal cyst. Total laparoscopic resection and Roux-en-Y reconstruction to two separated ducts

Reyes,

Sotomayor,

Inzunza

et al. 2024

Journal of Surgical Case Reports

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A choledochal cyst is a rare condition that requires surgical treatment to prevent complications, such as obstructive jaundice, cyst rupture, cholangitis, and the risk of malignancy. Complete cyst excision is considered the best option, as it reduces the risk of inflammation and the development of cholangiocarcinoma. Therefore, cholecystectomy and complete cyst resection followed by reconstruction with a Roux-en-Y hepaticojejunostomy is the treatment of choice. We present a case (with video) that shows the complete resection of a type I choledochal cyst with Roux-en-Y reconstruction of two separate ducts since the right posterior duct reached the cyst independently. The laparoscopic approach offers all the advantages of mini-invasive surgery and better visualization of the structures; however, biliary reconstruction to fine ducts implies a surgical challenge that requires high training in mini-invasive surgery.

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Robot-assisted resection of choledochal cyst in children

et al. 2023

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BackgroundThe emergence of the robotic surgery system has assisted the further development of minimally invasive surgery by facilitating more delicate and precise complex procedures. The purpose of this study was to present a study of robot-assisted resection of the choledochal cyst and to discuss the technical points.MethodsIn total, 133 patients who were diagnosed with a choledochal cyst and underwent surgery from April 2020 to February 2022 in the Children's Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. The data were collected including the clinical information of the patients, operative details, and postoperative outcomes.ResultsAmong these 133 patients, 99 underwent robot-assisted surgery and 34 underwent laparoscopic assisted surgery. The median operation time was 180 min, with an interquartile range (IQR) of 170–210 min for the robot-assisted group and 180 min with an IQR of 157.5–220 min in the laparoscopic assisted group (P = 0.290). The detection rate of 82.5% for the distal opening of the cystic type of choledochal cyst was higher in the robot-assisted group than that in the laparoscopic assisted group at 34.8% (P = 0.000). The postoperative hospital stay was shorter (P = 0.009) and the hospitalization expense was higher (P = 0.000) in the robot-assisted group than that of the laparoscopic assisted group. There was no significant difference between the two groups in terms of complications, postoperative indwelling days of the abdominal drainage tube, intraoperative blood loss, and postoperative fasting time (P > 0.05).ConclusionsRobot-assisted resection of choledochal cyst is safe and feasible, it is ideal for the patient requiring a meticulous operation, and its postoperative recovery was shorter than for traditional laparoscopy.

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Robotic versus laparoscopic surgery for choledochal cyst in children with aberrant hepatic ducts: A retrospective study

Cited by 3 publications

References 12 publications

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Variations of the hepatic artery and bile duct in patients with pancreaticobiliary maljunction: Impact on postoperative outcomes

Type I choledochal cyst. Total laparoscopic resection and Roux-en-Y reconstruction to two separated ducts

Robot-assisted resection of choledochal cyst in children

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