Comparison of Efficacy and Safety of Hepatico-Duodenostomy versus Hepatico-Jejenostomy after Excision of Choledochal Cyst in Children | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 13, Volume 98, Issue 1, January 2025, Pages 84-87 PDF (233.96 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.401103 | ||
| Abstract | ||
| Background: Choledochal cyst (CC) is a congenital dilatation of the biliary tract, most commonly the choledochus. Excision with biliary reconstruction has been established as standard management of CC. Objective: Thisstudy aimed to compare the outcome of the two most commonly performed methods of biliary reconstruction after excision of CC: Roux-en- Y hepaticojejunostomy (RYHJ) and hepaticoduodenostomy (HD). Patients and method: This was a retrospective cohort study included 24 patients diagnosed with CCto assess the outcome of the two biliary drainage methods: HD and RYHJ. Data were collected from patient files. The assessment criteria included: Operative time (OT), length of hospital stay (LOS), postoperative complications and reoperation rate. Outcome data were compared. Results: The Type Ia to type VIa ratio was 1:1 and there were no patients with other types of CC. HD group had relatively shorter operative time (2.07 hours for HD versus 3.26 hours for RYHJ), which was statistically significant (P <0.001). Also, shorter LOS for HD (4.75 days for HD versus 6.68 days for RYHJ with P >0.001), which was statistically significant. Ascending cholangitis was detected in one patient in HD group, while biliary reflux gastritis was detected in two patients in HD group and were statistically insignificant. Conclusion: Compared to RYHJ, HD required a single anastomosis and was associated with substantially less surgical time and LOS. It is more anatomical, physiological, and easy to perform but associated with statistically insignificant adverse events in comparison with RYHJ. | ||
| Keywords | ||
| Choledochal cyst; Hepaticoduodenostomy; Hepaticojejunostomy | ||
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