Single-port laparoscopic excision of choledochal cysts in neonates versus older infants and children: a comparative safety and feasibility study from a single-center 5-year experience - Summary - MDSpire
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Single-port laparoscopic excision of choledochal cysts in neonates versus older infants and children: a comparative safety and feasibility study from a single-center 5-year experience
To compare the feasibility, safety, and efficacy of single-port laparoscopic choledochal cyst excision with Roux-en-Y hepaticojejunostomy (SPCH) between neonates and older infants and children.
Key Findings:
70 patients included: 21 neonates and 49 older infants/children.
Neonates had larger cyst diameters (5.49 vs. 4.49 cm, P = 0.052) and higher rates of prenatal detection (85.7% vs. 49.0%, P = 0.004).
Older infants/children presented more frequently with pancreaticobiliary maljunction (44.9% vs. 4.8%, P = 0.001).
Operative outcomes were comparable with no significant differences in operative time (230.33 vs. 256.43 min) or blood loss (6.43 vs. 6.86 mL).
Neonates had no small diameter hepaticojejunostomy anastomoses (0.0% vs. 32.7%, P = 0.003) but longer postoperative stays (8.24 vs. 6.69 days, P = 0.04).
Complication rates were similar (4.8% vs. 2.0%, P = 0.53).
Interpretation:
Limitations:
Retrospective study design may limit the ability to draw definitive conclusions.
Small sample size, particularly in the neonatal group.
Conclusion:
Neonatal SPCH achieves comparable operative outcomes to older infants and children based on the findings of this study.
