Using laparoscopic double hemicircumferential running single-layer suture in hepaticojejunostomy for choledochal cysts in children

Background: To evaluate the feasibility and effectiveness of implementing a double-hemicircumferential running suture in laparoscopic hepaticojejunostomy for choledochal cysts (CDC) in children. Methods: From October 2001 to October 2009, we performed Roux-en-Y hepaticojejunostomy for 218 patients with congenital choledochal cyst. The choledochal cysts were excised laparoscopically. The jejunal Roux loop was fashioned extracorporeally by using hand-suturing technique. Laparoscopic "double-hemicircumferential" end to side anastomosis between the common hepatic duct stump and Roux loop was carried out. Early postoperative and follow-up results were analysed. Results: Double-hemicircumferential running suture was conducted for hepaticojejunostomy on 218 patients with choledochal cyst. The mean anastomosis time was 13.5 +/- 2.5min, and average bleeding amount was 9.1 +/- 6.1ml. The average postoperative hospital stay time was 7.4 +/- 2.4 days. The median follow-up period was 122 months. Morbidities associated with anastomosis, such as anastomotic stenosis, cholangitis, and stone formations do not occurred during follow-up period. Conclusions: The double-hemicircumferential running suture technique has the advantages of easy to operate in laparoscopy, saving time and less complications, thus it is an effective improvement of hepaticojejunostomy for choledochal cyst. (c) 2017 Published by Elsevier Inc.