Combination of laparoscopy and endoscopy for fusiform choledochal cysts

OBJECTIVE: The purpose of the study was to elucidate the efficacy of laparoscopy and endoscopy in the treatment of fusiform choledochal cysts (CDC). MATERIALS AND METHODS: Between June 2006 and June 2012, 18 patients with fusiform CDC were treated in our hospital. All the 18 patients presented abdominal pain, and 13 presented jaundice. 18 patients presented elevated serum and urinary amylase, when abdominal pain appeared. All the patients underwent laparoscopic and endoscopic surgery successfully. The clinical presentation, radiological features and surgical treatment were analyzed. The postoperative symptoms, laboratory examination and bile duct changes were evaluated during follow-up term. RESULTS: Intraoperative cholangiography showed filling defect, dilatation of the common channel and pancreatic ducts visualization in 18 patients, including 9 patients of pancreatic duct dilatation. The protein plugs and/or stones were removed completely under laparoscopy and endoscopy in 18 patients. Patients were followed-up for 3 months to 6 years. The biochemical and ultrasound examination showed no increase in pancreatic amylase and recurrence of the stones in the common channel and pancreatic duct. CONCLUSIONS: The children with congenital fusiform biliary dilatation presented abdominal pain. Patients presented elevated serum and urinary amylase, when abdominal pain occurred. Filling defect and dilatation of the common channel showed by cholangiography. Laparoscopy and endoscopy clearance of the protein plugs and/or stones in the common channel in congenital fusiform biliary dilatation is effective, and the long-term result is good.