Clinical Characteristics of Solitary Hilar Biliary Cyst in Children and Prognosis of Single-Port Laparoscopic Cysto-Cholecystostomy.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
OBJECTIVE: To summarize the clinical characteristics of children with solitary hilar biliary cysts and evaluate the medium- and long-term prognosis of single port laparoscopic cysto-cholecystostomy for this disease. METHODS: A retrospective analysis were performed on the data of 47 patients with solitary hilar bile duct cysts admitted to our center from January 2010 to January 2025. Among them, 44 cases meeting the surgical indications underwent single-port laparoscopic cysto-cholecystostomy, while 3 asymptomatic cases were followed up in outpatient clinic. The surgical patients were divided into prenatal diagnosis group and postnatal diagnosis group. Baseline data, imaging data, surgical records, laboratory tests and postoperative data were collected. Surgical complications were evaluated by Clavien-Dindo classification, postoperative biliary function was assessed by Lillemoe criteria, pathological results were evaluated by METAVIR scoring system, and long-term telephone follow-up was conducted after surgery. Relevant keywords were used to search PubMed and WOS databases for literature analysis. RESULTS: The average age at surgery was 17.18 months, and females accounted for 79.5 %. None of the patients had comorbid polycystic kidney disease. There were 36 patients in the prenatal diagnosis group, with a median gestational age at diagnosis of 24 weeks. 83.3 % of them had clinical symptoms, mainly jaundice and vomiting. In the postnatal diagnosis group with 8 patients, the main symptoms were abdominal pain and fever. Intraoperatively, the median maximum diameter of the cysts was 24 mm, all located in the right bile duct, and biliary sludge was present in all lesions. There were no postoperative deaths, and all complications were grade I. The liver function indices improved significantly after surgery, and the dilation range of the bile ducts was reduced in 95.5 % of the patients. Severe liver fibrosis was not found in the pathological examination. During a median follow - up of 78 months, the cystic dilation of the bile ducts completely disappeared in 43.2 % of the patients, the dilation range was reduced in 38.7 %, and sandy stones appeared in 18.2 % of the patients after 24 months post - surgery. No cholangitis symptoms occurred during the follow-up period. The outcomes were excellent in 43.2 % and good in 56.8 % of the patients. The literature search included 12 articles with a total of 18 patients. There were various surgical methods, and the short - term postoperative results were good. CONCLUSIONS: Solitary hilar biliary cysts are relatively rare in clinical practice and differ from Caroli's disease. Single - port laparoscopic cysto-cholecystostomy for the treatment of solitary hilar biliary cysts in children is easy to perform, has minimal trauma, few complications, and a good medium - and long - term prognosis. However, the occurrence of sandy stones still needs to be monitored after surgery, and long - term follow - up is recommended.