Zhang Jiayi,Li Jiamin,Liu Xingjian,et al.Retrospective analysis and treatment of mid/long-term complications after single-center laparoscopic radical resection of common bile duct cysts[J].Journal of Clinical Pediatric Surgery,,():227-231.[doi:10.3760/cma.j.cn101785-20251120-00072]
Retrospective analysis and treatment of mid/long-term complications after single-center laparoscopic radical resection of common bile duct cysts
- Abstract:
- Objective While there are numerous reports on perioperative complications after laparoscopic treatment of choledochal cysts,reports on medium-and long-term complications are relatively scarce.This study was intended to explore the incidence,influencing factors,management strategies and outcomes of medium-and long-term complications at Month 3 after laparoscopy for choledochal cysts.Methods Retrospective analysis was conducted for the clinical and follow-up data of 319 children undergoing laparoscopic radical resection for choledochal cysts between January 2010 and August 2025.The incidence,types,managements and outcomes of medium-and long-term postoperative complications were statistically examined.And the findings were summarized along with the relevant literature.Results After excluding 74 cases due to losing to follow-up or failure to meet the inclusion criteria,245 cases were ultimately included.Among them,12 cases (4.9%) developed medium/long-term complications of anastomotic stenosis (n=2,0.8%).One case was caused by an overriding right hepatic artery.Both were cured by laparoscopic re-do hepaticojejunostomy.Intrahepatic choledocholithiasis occurred (n=5,2.0%); one was cured post-ERCP stone extraction while the other four underwent laparoscopy plus choledochoscopic stone removal.Of these four,two were cured and one had residual minor stones in secondary bile ducts (asymptomatic,under conservative observation to date).Another recurrent case subsequently underwent partial hepatectomy at another hospital.One case of portal cavernous transformation improved after Rex shunting.Another case of adhesive intestinal obstruction improved with conservative measures.And among 5 cases of cholangitis,one was cured with conservative anti-inflammatory therapy while the remainders were associated with the aforementioned stone-related complications.Liver function abnormalities were noted (n=10,4.0%); two had no clear cause and one was associated with concurrent cholangitis (all improved with conservative treatment),while the remaining seven were related to structural complications,including stone (n=4),stenosis (n=2) and portal cavernous transformation (n=1).All improved after targeted treatment.Conclusions Medium/long-term complications in children after laparoscopic choledochal cyst surgery are closely related to surgical techniques,degree of preoperative inflammation and associated malformations.Establishing a comprehensive long-term postoperative follow-up system and enabling early identification and management of complications can improve long-term outcomes.
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Memo
收稿日期:2025-11-20。
基金项目:国家自然科学基金(82571975、82271743);山东大学齐鲁医学发展基金(34641390220001)
通讯作者:王东明,Email:wangdongming431x@163.com