ArticleSurgical endoscopy2025
Laparoscopy combined with intraoperative choledochoscopy for the treatment of cheoledochal cysts.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the efficacy of laparoscopy combined with intraoperative choledochoscopy in treating choledochal cysts and preventing postoperative complications. PATIENTS AND
methodsThis single-center retrospective study included 208 patients with Todani type I choledochal cysts treated laparoscopically from January 2016 to January 2023. Patients undergoing open surgery were excluded. Of these, 138 cases were treated with 6 Fr catheter irrigation (Group A), while 70 cases underwent intraoperative choledochoscopy for thorough irrigation and stone extraction (Group B). All patients were followed up for at least 18 months. Data collected included age at operation, gender, cyst diameter, preoperative manifestations, and postoperative outcomes. Statistical analysis was performed using Student's t-test for continuous data and Fisher's exact test for categorical data, with P < 0.05 indicating significance.
resultsClinical data of 187 cases were analyzed after excluding 21 lost to follow-up. No significant differences were found between Group A (n = 124) and Group B (n = 63) in age at operation (35.4 ± 17.2 months vs. 38.9 ± 19.6 months, P = 0.875), gender distribution (male:female ratio 34:90 vs. 13:50, P = 0.891), cyst diameter (25.6 ± 17.8 mm vs. 23.1 ± 17.5 mm, P = 0.758), or preoperative stone presence (54/124 vs. 25/63, P = 0.918). However, Group B had significantly lower incidence of residual/recurrent stones (1/63 vs. 14/124, P = 0.021) and postoperative pancreatitis (1/63 vs. 7/124, P = 0.044). At 6-month follow-up, intrahepatic bile duct dilation was significantly lower in Group B (0/63 vs. 6/124, P = 0.038), and hospital stay was shorter (9.1 ± 2.2 days vs. 10.7 ± 2.1 days, P = 0.003) without significant increase in total medical expenses (39059.6 ± 4115.3 RMB vs. 38422.8 ± 3341.6 RMB, P = 0.291).
conclusionsLaparoscopy combined with intraoperative choledochoscopy is feasible and effective in clearing biliary stones, preventing postoperative complications such as pancreatitis and bile duct dilation, and identifying hepatic duct stenosis in choledochal cyst treatment.
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