The Evaluation Of Total Laparoscopic Modidied Uncut Jejunal Loop To Treat ? Type Of Adult Choledochal Cyst

ObjectiveTo assess the feasibility, effectiveness, and safety of total laparoscopic modidied uncut jejunal loop to treat?type of adult choledochal cyst, summarize the surgical methods and skills, and compared with Roux-en-Y hepaticojejunostomy, analysis the advantages and disadvatages in the treatment of I type of adult choledochal cyst. MethodThe clinical data for 29 patients with I type of adult choledochal cyst from June 2009 to June 2015 were retrospectively analyzed. Of these patients, 15 underwent Roux-en-Y hepaticojejunostomy and 14 underwent total laparoscopic modidied uncut jejunal loop hepaticojejunostomy. The average time of operation, intro-operative blood loss, time to recovery of gastrointestinal function, postoperative hospitalization time and post-operative complication rate were compared between the two groups. ResultsAll the patients were operated successfully. The operative time of the Roux-en-Y group and the modidied uncut jejunal loop group was, respectively,(251.0±34.8)min and(204.3±32.5) min, P = 0.001< 0.05. The intro-operative blood loss was(133.0±30.4)ml and(56.8±33.6)ml, p=0.000<0.05. The time to postoperative recovery of gastrointestinal function was(5.1±1.2)d and(3.1±1.1)d, p = 0.000 < 0.05. The postoperative hospitalization time was(9.9±2.0)d and(7.8±1.6)d, p = 0.004 < 0.05. Significant differences in postoperative hospitalization time appear between two groups. The Roux-en-Y group had appeared biliary fistula(a case), pancreatic fistula(a case) and stress ulcer(a case). The modidied uncut jejunal loop group appeared biliary fistula(a case) and peritoneal effusion(a case). The post-operative complication rate of the two groups was 20% and 14.28%, and there was no significant differences in the two groups. ConclusionTotal laparoscopy modidied uncut jejunal loop has the advantage of shorter operative time, less intra-operative blood loss, faster recovery of gastrointestinal function, and shorter hospitalization than Roux-en-Y hepaticojejunostomy. So the operation scheme is worth of being generalized.