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Article: The impact of pre-operative cholecystostomy on laparoscopic excision of choledochal cyst in paediatric patients
Title | The impact of pre-operative cholecystostomy on laparoscopic excision of choledochal cyst in paediatric patients |
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Authors | |
Keywords | Biliary drainage Cholangitis Cholecystostomy Choledochal cyst Laparoscopy |
Issue Date | 17-Oct-2023 |
Publisher | Springer |
Citation | Pediatric Surgery International, 2023, v. 39, n. 1 How to Cite? |
Abstract | PurposeThis aim of this study was to identify the pre-operative risk factors for conversion during laparoscopic excision of choledochal cyst in paediatric patients. MethodsA retrospective single-centre study was carried out. All paediatric patients (< 18 years) who had undergone laparoscopic excision of choledochal cyst between 2004 and 2021 were reviewed. The outcome was conversion to open surgery and pre-operative factors that affected the conversion rate were analyzed. ResultsSixty-one patients were included. Conversion was required in 24 cases (39.3%). There was no difference in the conversion rate between the first (before 2012, n = 30) and second (after 2012, n = 31) half of the series (36.7% vs. 42.0%, p = 0.674). Majority was type 1 cyst (86.8%) and the median cyst size was 4.6 cm (IQR: 2.2–6.4 cm). Antenatal diagnosis was available in 18 patients (29.5%). The median age at operation was 23.0 months (IQR: 8.0–72.0 months). Pre-operatively, 19 patients (31.1%) suffered from cholangitis and 5 (8.2%) of them required cholecystostomy. Comparing patients with successful laparoscopic surgery (L) and converted cases (C), there were no differences in the age at operation (p = 0.74), cyst size (p = 0.35), availability of antenatal diagnosis (p = 0.23) and cholangitic episodes (p = 0.40). However, a higher percentage of patients required cholecystostomy in the converted group (L vs. C = 2.7% vs. 16.7%, p = 0.05). Using logistic regression analysis, it was also a risk factor for conversion (OR = 3.5 [1.37–5.21], p = 0.05). ConclusionPre-operative cholecystostomy is a potential risk factor for conversion during laparoscopic excision of choledochal cyst in children. |
Persistent Identifier | http://hdl.handle.net/10722/339123 |
ISSN | 2023 Impact Factor: 1.5 2023 SCImago Journal Rankings: 0.548 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chung, Patrick Ho Yu | - |
dc.contributor.author | Yeung, Fanny | - |
dc.contributor.author | Ma, Marco King In | - |
dc.contributor.author | Wong, Kenneth Kak Yuen | - |
dc.date.accessioned | 2024-03-11T10:34:04Z | - |
dc.date.available | 2024-03-11T10:34:04Z | - |
dc.date.issued | 2023-10-17 | - |
dc.identifier.citation | Pediatric Surgery International, 2023, v. 39, n. 1 | - |
dc.identifier.issn | 0179-0358 | - |
dc.identifier.uri | http://hdl.handle.net/10722/339123 | - |
dc.description.abstract | <h3>Purpose</h3><p>This aim of this study was to identify the pre-operative risk factors for conversion during laparoscopic excision of choledochal cyst in paediatric patients.</p><h3>Methods</h3><p>A retrospective single-centre study was carried out. All paediatric patients (< 18 years) who had undergone laparoscopic excision of choledochal cyst between 2004 and 2021 were reviewed. The outcome was conversion to open surgery and pre-operative factors that affected the conversion rate were analyzed.</p><h3>Results</h3><p>Sixty-one patients were included. Conversion was required in 24 cases (39.3%). There was no difference in the conversion rate between the first (before 2012, <em>n</em> = 30) and second (after 2012, <em>n</em> = 31) half of the series (36.7% vs. 42.0%, <em>p</em> = 0.674). Majority was type 1 cyst (86.8%) and the median cyst size was 4.6 cm (IQR: 2.2–6.4 cm). Antenatal diagnosis was available in 18 patients (29.5%). The median age at operation was 23.0 months (IQR: 8.0–72.0 months). Pre-operatively, 19 patients (31.1%) suffered from cholangitis and 5 (8.2%) of them required cholecystostomy. Comparing patients with successful laparoscopic surgery (L) and converted cases (C), there were no differences in the age at operation (<em>p</em> = 0.74), cyst size (<em>p</em> = 0.35), availability of antenatal diagnosis (<em>p</em> = 0.23) and cholangitic episodes (<em>p</em> = 0.40). However, a higher percentage of patients required cholecystostomy in the converted group (L vs. C = 2.7% vs. 16.7%, <em>p</em> = 0.05). Using logistic regression analysis, it was also a risk factor for conversion (OR = 3.5 [1.37–5.21], <em>p</em> = 0.05).</p><h3>Conclusion</h3><p>Pre-operative cholecystostomy is a potential risk factor for conversion during laparoscopic excision of choledochal cyst in children.</p> | - |
dc.language | eng | - |
dc.publisher | Springer | - |
dc.relation.ispartof | Pediatric Surgery International | - |
dc.subject | Biliary drainage | - |
dc.subject | Cholangitis | - |
dc.subject | Cholecystostomy | - |
dc.subject | Choledochal cyst | - |
dc.subject | Laparoscopy | - |
dc.title | The impact of pre-operative cholecystostomy on laparoscopic excision of choledochal cyst in paediatric patients | - |
dc.type | Article | - |
dc.description.nature | preprint | - |
dc.identifier.doi | 10.1007/s00383-023-05562-3 | - |
dc.identifier.scopus | eid_2-s2.0-85174305099 | - |
dc.identifier.volume | 39 | - |
dc.identifier.issue | 1 | - |
dc.identifier.eissn | 1437-9813 | - |
dc.identifier.isi | WOS:001090929200001 | - |
dc.identifier.issnl | 0179-0358 | - |