Page 31 - World Journal of Laparoscopic Surgery

Laparoscopic Choledochal Cyst Resection with Biliary Reconstruction
underwent laparoscopic CC resection and simplified common bile Table 1: Todani classification of the bile duct cyst
duct reconstruction at a hepatobiliary referral center in Bogota, Type Characteristics
Colombia between January 2013 and June 2018. I Solitary extrahepatic cyst
The following variables were evaluated: age, sex, CC type
(according to Todani classification), diagnosis, surgery time, II Extrahepatic diverticulum
bleeding, biliary leakage, conversion rates, oral feeding tolerance, III Intraduodenal diverticulum (Choledochocele)
Intensive care unit (ICU) stay, hospital stay time, need of IVA Extra- and intrahepatic cyst
reintervention, incidence of stenosis, mortality and incidence of IVB Multiple extrahepatic cyst
cholangiocarcinoma with a postoperative follow-up of at least V Multiple intrahepatic cyst (Caroli's disease)
2 years.
All patients had a pre-surgical multidisciplinary team
assessment performed by gastroenterology and general surgery. extrinsic bile duct compression (e.g., periampullary tumors), or
Patient consent for laparoscopic choledochal cyst resection and cholangiocarcinoma, patients who had already been treated
simplified common bile duct reconstruction was obtained before surgically for CC at another center, patients who were coursing with
the procedure was started. The study protocol was approved by cholangitis and patients had a contraindication for laparoscopic
the ethics committee at our institution and it was implemented surgery.
in accordance with the Declaration of Helsinki and good clinical
practice guidelines.

surgIcAl technIque
IndIcAtIons Patient Preparation
In order to include patients in this study, the following criteria All patients prepared for laparoscopic choledochal cyst resection
were evaluated. Only patients over 18 years of age, who had a and simplified common bile duct reconstruction were preparer
diagnosis of CC (Todani type I, II, and IVb) (Fig. 1) and Table 1 who as if they had an open operation, 8-hour fasting and antibiotic
were taken to laparoscopic CC resection and simplified common prophylaxis were indicated according to the latest good clinical
bile duct reconstruction were selected. Patients with the following practice guidelines. Patients and their families were informed of
characteristics were excluded from the study: those diagnosed with the surgical risk, possible complications, such as bleeding, infection,
CC type III, IVa, V, and Child Pugh B (or higher) hepatic cirrhosis, the need for additional trocars, open conversion, and mortality.

Fig. 1: Todani classification in 3D-model by Pulido J

World Journal of Laparoscopic Surgery, Volume 12 Issue 2 (May–August 2019) 77