Laparoscopic management of choledochal cysts: is a keyhole view missing the big picture?

摘要: In recent years, numerous articles have promoted laparoscopic surgical treatment of choledochal cysts in children. Most these reports assert that excision and biliary reconstruction are as safe open surgery achieve equivalent or better results. However, conclusions based on retrospective analyses with median follow-up periods rarely exceed 5 years. Closer scrutiny the literature indicates optimum procedure for treating type I most IVa cysts, namely radical extrahepatic bile ducts by wide hilar hepaticoenterostomy, preferably hepaticojejunostomy, is not being carried out cases. Performing a less exposes patients to greater long-term risk bilioenteric stricture its complications malignant change residual ducts. Currently, outcomes eclipsed short-term gains techniques. The prime objective management health patient; techniques simply another method performing they should become standard care unless similar best practice surgery.