Background: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs.
Methods: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B). The operative time, intraoperative bleeding, length of stay, and postoperative complications were analyzed.
Results: Group A comprised 6 patients (2 males, 4 females; mean age, 29months), and Group B comprised 26 patients (2 males, 24 females; mean age, 41months). All patients underwent single-stage complete excision with Roux-en-Y hepaticojejunostomy. There were no significant differences in the operative time, bleeding, and/or length of stay. There were no operative deaths or complications such as anastomosis leakage or postoperative cholangitis, but a pancreatic fistula developed in one patient in Group A and two in Group B.
Conclusion: Single-stage excision for a perforated CC is feasible if the patient's condition is stable.
Levels of evidence: Treatment Study, LEVELIII.
Keywords: Choledochal cyst; Perforation.
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