Single-incision versus conventional laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts: a case-control study.

BACKGROUND: The aim of this study was to compare the efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) with that of conventional laparoscopic hepaticojejunostomy (CLH) for children with choledochal cysts (CDCs).

METHODS: Patients undergoing SILH between April 2011 and April 2012 were matched with those undergoing CLH between January 2009 and April 2011 for age, sex, CDC types, size, and operative surgeon. The operating time, postoperative hospital stay, time to full feed, postoperative complications, and perioperative laboratory tests were compared.

RESULTS: A total of 150 patients (SILH 75, CLH 75) were evaluated. Median follow-up periods of SILH and CLH groups were 12 and 34 months, respectively. The postoperative hospital stay and time required for resumption of full diet were similar for the two groups (p = 0.93 and 0.16, respectively). Early in the series, one (1.3 %) SILH patient developed bile leak. It was successfully managed with 10 days of drainage. No mortality or morbidities-anastomotic stenosis, cholangitis, pancreatic leak, intestinal obstruction, intrahepatic reflux-were encountered. Overall complication rates were identical in the two groups (p = 0.32).

CONCLUSIONS: SILH is safe in the hands of experienced laparoscopic hepaticobiliary surgeons. It achieves comparable outcomes with less surgical scar.