Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
Topic overview
National database study comparing laparoscopic versus open choledochal cyst resection in 577 pediatric patients found laparoscopic approach associated with shorter hospital stays, lower costs, and fewer complications despite less frequent use. Anastomotic technique differed by approach, with hepaticoduodenostomy favored laparoscopically and Roux-en-Y hepaticojejunostomy preferred for open cases.
Key takeaways
- Laparoscopic choledochal cyst resection in children has shorter hospital stay, lower costs, and fewer complications than open surgery.
- Hepaticoduodenostomy is preferred in laparoscopic cases (71%) while Roux-en-Y hepaticojejunostomy is more common in open cases (86%).
- No significant difference in post-operative cholangitis or mortality between laparoscopic and open approaches.
- Hepaticoduodenostomy causes more short-term GI dysfunction; Roux-en-Y has higher rates of sepsis, wound infection, and respiratory issues.
- Laparoscopic approach is underutilized (28% of cases) despite demonstrated safety and superior short-term outcomes in pediatric patients.
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