Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Can stenosis of the hilar hepatic duct affect postoperative outcome?

Go Miyano, Mariko Koyama, Hiromu Miyake, Masakatsu Kaneshiro, Keiichi Morita, Hideaki Nakajima, Masaya Yamoto, Hiroshi Nouso, Koji Fukumoto, Naoto Urushihara

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

INTRODUCTION: The aim of this study was to compare laparoscopic hepaticojejunostomy (LHJ) and open hepaticojejunostomy (OHJ) for choledochal cyst associated with hilar hepatic duct stenosis (HHDS).

METHODS: Data collection was prospective for LHJ cases from 2009 and retrospective for OHJ cases from 2003 to 2008. Data were compared with respect to HHDS. HHDS was incised longitudinally as required during hilar hepatic ductoplasty.

RESULTS: Fifty-eight subjects were studied (LHJ: n = 27, 4 boys, 23 girls; OHJ: n = 31; 6 boys, 25 girls). HHDS was present in 10 LHJ cases and 10 OHJ cases. Todani classification of choledochal cyst in LHJ patients was type 1A (n = 16) and type 4A (n = 11), and in OHJ patients, it was type 1A (n = 19) and type 4A (n = 12). There were significant differences between LHJ and OHJ with regard to mean operative time (386 vs 341 min), mean blood loss (5.9 vs 18.4 mL), recommencement of enteral feeding (3.9 vs 6.4 days), and hospital stay (11.7 vs 15.5 days) (all P < 0.05). Hepatic ductoplasty was performed in 23 LHJ patients and in 21 OHJ patients. There were no intraoperative complications and no conversions to OHJ. There were no significant differences between LHJ and OHJ, regardless of the presence of HHDS, for postoperative complications, which included minor bile leakage, anastomotic stricture, and intestinal obstruction.

CONCLUSION: LHJ is as effective as OHJ for the treatment of choledochal cysts irrespective of the presence of HHDS and the need for hepatic ductoplasty.

Original languageEnglish
Pages (from-to)295-300
Number of pages6
JournalAsian journal of endoscopic surgery
Volume10
Issue number3
DOIs
Publication statusPublished - Aug 1 2017
Externally publishedYes

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Common Hepatic Duct
Pathologic Constriction
Choledochal Cyst
Liver
Anastomotic Leak
Intestinal Obstruction
Intraoperative Complications
Enteral Nutrition
Operative Time
Bile
Length of Stay

Keywords

  • Bile duct stenosis
  • choledochal cyst
  • laparoscopic hepaticojejunostomy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Can stenosis of the hilar hepatic duct affect postoperative outcome? / Miyano, Go; Koyama, Mariko; Miyake, Hiromu; Kaneshiro, Masakatsu; Morita, Keiichi; Nakajima, Hideaki; Yamoto, Masaya; Nouso, Hiroshi; Fukumoto, Koji; Urushihara, Naoto.

In: Asian journal of endoscopic surgery, Vol. 10, No. 3, 01.08.2017, p. 295-300.

Research output: Contribution to journalArticle

Miyano, G, Koyama, M, Miyake, H, Kaneshiro, M, Morita, K, Nakajima, H, Yamoto, M, Nouso, H, Fukumoto, K & Urushihara, N 2017, 'Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Can stenosis of the hilar hepatic duct affect postoperative outcome?', Asian journal of endoscopic surgery, vol. 10, no. 3, pp. 295-300. https://doi.org/10.1111/ases.12358
Miyano, Go ; Koyama, Mariko ; Miyake, Hiromu ; Kaneshiro, Masakatsu ; Morita, Keiichi ; Nakajima, Hideaki ; Yamoto, Masaya ; Nouso, Hiroshi ; Fukumoto, Koji ; Urushihara, Naoto. / Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Can stenosis of the hilar hepatic duct affect postoperative outcome?. In: Asian journal of endoscopic surgery. 2017 ; Vol. 10, No. 3. pp. 295-300.
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AU - Miyano, Go

AU - Koyama, Mariko

AU - Miyake, Hiromu

AU - Kaneshiro, Masakatsu

AU - Morita, Keiichi

AU - Nakajima, Hideaki

AU - Yamoto, Masaya

AU - Nouso, Hiroshi

AU - Fukumoto, Koji

AU - Urushihara, Naoto

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N2 - INTRODUCTION: The aim of this study was to compare laparoscopic hepaticojejunostomy (LHJ) and open hepaticojejunostomy (OHJ) for choledochal cyst associated with hilar hepatic duct stenosis (HHDS).METHODS: Data collection was prospective for LHJ cases from 2009 and retrospective for OHJ cases from 2003 to 2008. Data were compared with respect to HHDS. HHDS was incised longitudinally as required during hilar hepatic ductoplasty.RESULTS: Fifty-eight subjects were studied (LHJ: n = 27, 4 boys, 23 girls; OHJ: n = 31; 6 boys, 25 girls). HHDS was present in 10 LHJ cases and 10 OHJ cases. Todani classification of choledochal cyst in LHJ patients was type 1A (n = 16) and type 4A (n = 11), and in OHJ patients, it was type 1A (n = 19) and type 4A (n = 12). There were significant differences between LHJ and OHJ with regard to mean operative time (386 vs 341 min), mean blood loss (5.9 vs 18.4 mL), recommencement of enteral feeding (3.9 vs 6.4 days), and hospital stay (11.7 vs 15.5 days) (all P < 0.05). Hepatic ductoplasty was performed in 23 LHJ patients and in 21 OHJ patients. There were no intraoperative complications and no conversions to OHJ. There were no significant differences between LHJ and OHJ, regardless of the presence of HHDS, for postoperative complications, which included minor bile leakage, anastomotic stricture, and intestinal obstruction.CONCLUSION: LHJ is as effective as OHJ for the treatment of choledochal cysts irrespective of the presence of HHDS and the need for hepatic ductoplasty.

AB - INTRODUCTION: The aim of this study was to compare laparoscopic hepaticojejunostomy (LHJ) and open hepaticojejunostomy (OHJ) for choledochal cyst associated with hilar hepatic duct stenosis (HHDS).METHODS: Data collection was prospective for LHJ cases from 2009 and retrospective for OHJ cases from 2003 to 2008. Data were compared with respect to HHDS. HHDS was incised longitudinally as required during hilar hepatic ductoplasty.RESULTS: Fifty-eight subjects were studied (LHJ: n = 27, 4 boys, 23 girls; OHJ: n = 31; 6 boys, 25 girls). HHDS was present in 10 LHJ cases and 10 OHJ cases. Todani classification of choledochal cyst in LHJ patients was type 1A (n = 16) and type 4A (n = 11), and in OHJ patients, it was type 1A (n = 19) and type 4A (n = 12). There were significant differences between LHJ and OHJ with regard to mean operative time (386 vs 341 min), mean blood loss (5.9 vs 18.4 mL), recommencement of enteral feeding (3.9 vs 6.4 days), and hospital stay (11.7 vs 15.5 days) (all P < 0.05). Hepatic ductoplasty was performed in 23 LHJ patients and in 21 OHJ patients. There were no intraoperative complications and no conversions to OHJ. There were no significant differences between LHJ and OHJ, regardless of the presence of HHDS, for postoperative complications, which included minor bile leakage, anastomotic stricture, and intestinal obstruction.CONCLUSION: LHJ is as effective as OHJ for the treatment of choledochal cysts irrespective of the presence of HHDS and the need for hepatic ductoplasty.

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KW - choledochal cyst

KW - laparoscopic hepaticojejunostomy

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