Minilaparotomy for cystic transformations of bile ducts in children

   Aim. To improve treatment outcomes for children with common bile duct cysts.

   Materials and methods. The study enrolled children with common bile duct cysts (n = 84) examined from January 2010 to November 2023. All patients underwent cyst excision, Roux-en-Y hepaticojejunostomy laparoscopically or from a minilaparatomy access. A comparative analysis of the treatment outcomes was carried out to select the optimal access. The timing of surgery, as well as early and late postoperative complications were analyzed.

   Results. The timing of surgery from the minilaparotomy access was shorter. Defecation in children of the minilaparotomy subgroup appeared 3 times earlier than in children after laparoscopic hepaticojejunostomy, largely due to earlier enteral load. A good treatment outcome was observed in 92 % of patients who underwent intervention from a minilaparotomy access compared to 52.2 % of patients who underwent laparoscopic surgery.

   Conclusion. Currently, laparoscopic access is a non-optimal method for treatment of children with common bile duct cysts. Minilaparotomy appears to be a promising surgical access in children and may be proposed as a standard for common bile duct cysts.

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