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Open Access Highly Accessed Research article

Surgical treatment of congenital biliary duct cyst

De-chun Wang, Zi-pei Liu, Zhi-hua Li, Da-jiang Li, Jian Chen, Shu-guo Zheng, Yu He, Ping Bie and Shu-guang Wang*

Author Affiliations

Institute of Hepatobiliary Surgery of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China

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BMC Gastroenterology 2012, 12:29  doi:10.1186/1471-230X-12-29

Published: 30 March 2012

Abstract

Background

It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision.

Methods

From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ≤ 3 years), the immaturity group (3 < age ≤ 18 years), and the maturity group (age > 18 years), and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups.

Results

Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p < 0.05) (lowest in the infant group), and intraoperative blood loss also had apparent diversity (p < 0.05). Furthermore, long-term outcomes (secondary cholangiolithiasis, stoma stenosis and cholangiocarcinoma) showed no significant difference between different groups (p > 0.05).

Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05) between the laparoscopic and the open surgery groups.

Conclusions

We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.

Keywords:
Congenital biliary duct cyst; Total cyst excision; Laparoscopic resection