Laparoscopic Excision of Ruptured Choledochal Cyst

Abstract

Introduction:

Ruptured choledochal cyst is an unusual problem in children that has a variety of therapeutic approaches reported through case series in the literature. ^{1 –3} Laparoscopic excision of the cyst is now commonly performed when no signs of perforation are present. Here we present a case of effective laparoscopic excision of a ruptured choleochal cyst after a course of antibiotics and percutaneous drainage by interventional radiology.

Methods:

A 2-year-old female presented with a 5-day history of abdominal pain. A CT scan showed ascites and a choledochal cyst. The patient underwent percutaneous drainage of bilious ascites and magnetic resonance cholangiopancreatography was obtained and further confirmed the diagnosis of ruptured placement of a transhepatic biliary drainage catheter by interventional radiology. Six weeks later, she underwent effective laparoscopic excision of the ruptured cyst.

Results:

The operation was completed with a laparoscopic approach by removing the cyst and performing a hepaticoduodenostomy. The perforation was in the posterior wall of the cyst and significant inflammation required mucosectomy of that wall. The patient recovered without complication.

Conclusion:

Percutaneous drainage and laparoscopic excision of a ruptured choledochal cyst present a safe option for the management of this unusual and often complicated problem.

No competing financial interests exist.

Runtime of video: 4 mins 16 secs