Oral Presentation 4

Laparoscopic surgery for choledochal cyst in children

Li Long
Capital Institute of Pediatrics

Professor Li is currently Professor of Pediatric Surgery at the Department of Pediatric Surgery, The Capital Institution of Pediatrics, Beijing, China. He graduated from the China Medical University in 1985 and completed his postgraduate pediatric surgical training and started his career as a full-time pediatric surgeon in Beijing Children's Hospital. In 1997 and 1999 he was supported by Dr Cheng Yu Tung Fellowships to train as Visiting Research and Clinical Fellow respectively in the Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong. Since 2000, Professor Li and his team, cooperated with Professor PKH Tam and Dr KKY Wong, have developed a large pediatric laparoscopic surgery programme in China. He also established pediatric liver transplantation programme with the first successful pediatric liver transplantation in Beijing in November 2001 under the guidance of Professor ST Fan and Professor CM Lo. He has contributed to more than 320 articles, 2 books, 1 set of laparoscopic video and several book chapters to the pediatric surgery literatures. Professor Li has special interests in Pediatric hepatobiliary surgery and pediatric minimally invasive surgery and his team has undertaken more than 30,000 laparoscopic operations for children.

Abstract

Laparoscopy enables surgeons to approach the surgical conditions from a new perspective. Laparoscopic surgery has revolutionized the treatment of choledochal cysts (CDC). Yet, this new technique requires objective evaluations. We have examined the controversies about the timing of surgery for antenatally diagnosis, simplified classification and laparoscopic distal cyst dissection and ligation, ductoplasty for hepatic duct stenosis, protein plugs clearance in common channel, Roux loop length, SILH in CDC children and redo ductoplasty for biliary stenosis. In the hands of experts, laparoscopic excision of the cyst and Roux-en-Y hepaticojejunostomy is safe and effective approach. We provide our opinions on these issues based on our experience and publications. We conclude that the main outcomes of the laparoscopic approach have improved over those of the open surgery. The better wound cosmesis and reductions of surgical trauma and postoperative complications are the advantages.