Laparoscopic excision versus open excision for the treatment of choledochal cysts: a systematic review and meta-analysis

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OBJECTIVE

To determine if laparoscopic excision is more effective than open excision in the treatment of choledochal cysts.

MATERIAL AND METHODS

A systematic review of randomized clinical trials in 3 databases measuring the efficacy of laparoscopic and open excision of choledochal cysts was performed. The authors considered international and national reports, whose results were analyzed in detail.

RESULTS

Mean duration of laparoscopic excision was 51 min, open excision — 35.4 min. Length of hospital-stay after laparoscopic excision ranged between 5 and 74 days, after open excision — between 7 and 146 days. Bile leakage rate was 1-2% and 4%, respectively. Laparoscopic excision was followed by lower complication rate. Morbidity and mortality in laparoscopic excision was 20% and 0%, in open excision — 60% and 3.3%, respectively.

CONCLUSION

Laparoscopic excision is more effective than open excision in the treatment of choledochal cysts.

Keywords:

choledochal cyst

laparoscopic excision

open excision

Authors:

Plasencia G.

Antenor Orrego Private University

ORCID: 0009-0003-5780-5336

Alvarado J.C.

Regional Hospital of Trujillo

Corvera C.Z.

Cientifica del Sur University

ORCID: 0000-0001-5918-8261

Angulo W.P.

Antenor Orrego Private University

ORCID: 0000-0003-1325-2787

Received:

21.07.2023

Accepted:

04.08.2023

List of references:

Söreide K, Körner H, Havnen J, Söreide JA. Bile duct cysts in adults. Br J Surg [Internet]. 2004;91(12):1538-1548. https://sci-hub.se/10.1002/bjs.4815
Todani T, Wantanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts. Am J Surg [Internet]. 1977;134:263-269. https://sci-hub.se/10.1016/0002-9610(77)90359-2
Khandelwal C, Anand U, Kumar B, Priyadarshi RN. Diagnosis and Management of Choledochal Cysts. Indian J Surg [Internet]. 2012;74(1):29-34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259169/pdf/12262_2011_Article_388.pdf
O’ Neill JA. Choledochal cyst. Curr Probl Surg [Internet]. 1992;29(6):361-410. https://sci-hub.se/10.1016/0011-3840(92)90025-x
Moslim MA, Takahashi H, Seifarth FG, Walsh RM, Morris-Stiff G. Choledochal Cyst Disease in a Western Center: A 30-Year Experience. J Gastrointest Surg [Internet]. 2016;20(8):1453-1463. https://doi.org/10.1007/s11605-016-3181-4
Bhavsar MS, Vora HB, Giriyappa VH. Choledochal cysts : A review of literature. Saudi J Gastroenterol [Internet]. 2012;18(4):230-236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409882/pdf/SJG-18-230.pdf
Stain SC, Guthrie CR, Yellin AE, Donovan AJ. Choledochal cyst in the adult. Ann Surg [Internet]. 1995;222(2):128-133. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234770/pdf/annsurg00042-0034.pdf
Xia HT, Yang T, Liang B, Zeng JP, Dong JH. Treatment and outcomes of adults with remnant intrapancreatic choledochal cysts. Surgery [Internet]. 2016;159(2):418-425. https://doi.org/10.1016/j.surg.2015.04.042
Qiao G, Li L, Li S, Tang S, Wang B, Xi H, et al. Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China: A multicenter study. Surg Endosc [Internet]. 2014;29(1):140-144. https://sci-hub.se/10.1007/s00464-014-3667-7
Antonacci N, Ricci C, Taffurelli G, Casadei R, Minni F. Systematic review of laparoscopic versus open surgery in the treatment of non-parasitic liver cysts. Updates Surg [Internet]. 2014;66(4):231-238. https://sci-hub.se/10.1007/s13304-014-0270-3
Zhen C, Xia Z, Long L, Lishuang M, Pu Y, Wenjuan Z, et al. Laparoscopic excision versus open excision for the treatment of choledochal cysts: A systematic review and meta-analysis. Int Surg [Internet]. 2015;100(1):115-122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301275/pdf/i0020-8868-100-1-115.pdf
Shen HJ, Xu M, Zhu HY, Yang C, Li F, Li K wei, et al. Laparoscopic versus open surgery in children with choledochal cysts: a meta-analysis. Pediatr Surg Int [Internet]. 2015;31(6):529-534. https://sci-hub.se/10.1007/s00383-015-3705-0
Sokouti M, Sadeghi R, Pashazadeh S, Abadi SEH, Sokouti M, Rezaei-hachesu P, et al. A systematic review and meta-analysis on the treatment of liver hydatid cyst: Comparing laparoscopic and open surgeries. Arab J Gastroenterol [Internet]. 2017;18(3):127-135. https://doi.org/10.1016/j.ajg.2017.09.010
Sun R, Zhao N, Zhao K, Su Z, Zhang Y, Diao M, et al. Comparison of efficacy and safety of laparoscopic excision and open operation in children with choledochal cysts: A systematic review and update meta-analysis. PLoS One [Internet]. 2020;15(9 September):1-16. https://doi.org/10.1371/journal.pone.0239857
Mego A. Efectividad de la cirugía laparoscópica versus cirugía convencional para favorecer la recuperación del paciente post operado de apendicitis [Internet]. Universidad Privada Norbert Wiener; 2016. https://repositorio.uwiener.edu.pe/bitstream/handle/123456789/419/T061_08337671_S.pdf?sequence=1&isAllowed=y
Yépez C. Estudio comparativo sobre las complicaciones de apendicectomía laparoscópica y apendicectomía abierta en gestantes. Hospital Regional Docente de Trujillo 2002—2014 [Internet]. Universidad Nacional de Trujillo; 2016. https://dspace.unitru.edu.pe/bitstream/handle/UNITRU/1210/YépezCalderónCristianAlfonso.pdf?sequence=1&isAllowed=y
Berrocal W. Complicaciones de cirugía laparoscópica en apendicitis aguda complicada en menores de catorce años [Internet]. Universidad San Martín de Porres; 2018. https://repositorio.usmp.edu.pe/bitstream/handle/20.500.12727/4771/berrocal_awh.pdf?sequence=1&isAllowed=y
Cornejo-Carrasco CE, Carrasco-Rivera CE. Resultados clínicos y económicos de la cirugía laparoscópica versus abierta en el tratamiento del quiste hidatídico hepático. Rev la Fac Med Humana [Internet]. 2020;20(3):404-4-11. https://www.scielo.org.pe/pdf/rfmh/v20n3/2308-0531-rfmh-20-03-404.pdf
Panduro-Correa V, Dámaso-Mata B, Loza-Munárriz C, Herrera-Matta JJ, Arteaga-Livias K. Comparison of open gastrectomy and the laparoscopic procedure in advanced gastric cancer. Rev Gastroenterol México [Internet]. 2020;85(1):32-41. https://doi.org/10.1016/j.rgmxen.2019.01.009
Instituto Nacional del Cáncer (NIH). Laparoscopía [Internet]. 2020 [cited 2021 Oct 10]. https://www.cancer.gov/espanol/publicaciones/diccionarios/diccionario-cancer/def/laparoscopia
Cassi LG. Cirugía Laparoscopia. Rev Med Hondur [Internet]. 1992;60. https://revistamedicahondurena.hn/assets/Uploads/Vol60-2-1992-7.pdf
Columna y Traumatología. Tipos de cirugía [Internet]. 2020 [cited 2021 Oct 10]. https://www.columnaytraumatologia.com/lesiones-y-tratamientos/tipos-de-cirugia.html
Machain Vega GM, Miranda C, Amarilla J, Bogado O, Careaga D, Guillén W, et al. Ventajas y desventajas de la cirugía videolaparoscopica sobre la cirugía abierta en colecistectomía realizadas en la segunda cátedra de clínica quirúrgica, Hospital de Clínicas, San Lorenzo, Paraguay, Paraguay 2017. Cir Paraguaya [Internet]. 2017;41(3):21-32. https://scielo.iics.una.py/pdf/sopaci/v41n3/2307-0420-sopaci-41-03-00021.pdf
Sánchez J, Gómez S, Morales C, Hoyos SI. Quistes del colédoco. Rev Colomb Cir [Internet]. 2015;30(4):296-305. https://www.scielo.org.co/pdf/rcci/v30n4/v30n4a7.pdf
Salmerón JI, Del Amo Fernández A. Antibiotic prophylaxis in Oral and Maxillofacial Surgery. Med Oral Patol Oral Cir Bucal [Internet]. 2006;11:292-296. https://www.medicinaoral.com/pubmed/medoralv11_i3_p292.pdf
Superintendencia de Salud de Chile. Hospitalización [Internet]. 2020 [cited 2021 Oct 10]. https://www.supersalud.gob.cl/difusion/665/w3-propertyvalue-2426.html
Mayo Clinic. Función intestinal [Internet]. 2021 [cited 2021 Oct 10]. https://www.mayoclinic.org/es-es/diseases-conditions/fecal-incontinence/multimedia/bowel-function/img-20006015#:~:text=Eltractodigestivocontieneun,válvulaenelsistemadigestivo.
American Society of Anesthesiologists Task Force on Perioperative Blood Management. Practice Guidelines for Perioperative Blood Management. Anesthesiology [Internet]. 2015;122(2):241-275. https://sci-hub.se/10.1097/ALN.0000000000000463
Sánchez García NL, Pérez Triana F, Periles Gordillo U, Hernández Casas Y, Elvirez Gutiérrez Á. Tratamiento endoscópico de la fuga biliar postcolecistectomía. Presentación de dos casos. Medisur [Internet]. 2019;17(3):437-442. https://www.medigraphic.com/pdfs/rma/cma-2017/cmas171df.pdf

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