Roux-en-Y hepaticojejunostomy versus hepaticoduodenostomy after excision of choledochal cyst: A randomized clinical trial and experience in a tertiary care hospital
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: Excision of choledochal cyst is required to relieve biliary obstruction thereby protecting the liver and pancreas as well as to prevent malignancy in long term. But controversy persists in the two existing techniques of biliary reconstruction after cyst excision. Aim: To analyze the clinical presentation, incidence and types of choledochal cyst and our experience in management of these congenital anomalies. To compare the advantages and disadvantages between two modalities of biliary reconstruction. Methods: A prospective, controlled, clinical trial was conducted on patients with choledochal cyst in a tertiary care pediatric surgery hospital. They were divided into two groups; Group–A: Patients in whom biliary reconstruction was done by Roux-en-Y hepaticojejunostomy, Group-B: Biliary reconstruction done by Hepaticoduodenostomy. The two groups were compared in respect to clinical course, types of cyst, surgical difficulties with special emphasis on operating time, postoperative complications. Results: Choledochal cysts accounted for 0.79% of total admissions at our institute. Out of 31 admitted cases, 22 cases were enrolled in the study. The number of patients in group A were 10 and in group B were 12. Abdominal pain was the commonest presenting feature and Type I choledochal cyst was the most common finding. The average duration of surgery was less in group B (1 hour 25 min) than in group A (2 hours and 10 min). Conclusion: Biliary reconstruction by Hepaticoduodenostomy takes significantly less operative time than Roux-en-Y hepaticojejunostomy (P<0.05) and needs single anastomosis. It is more anatomical, physiological, easy to perform and associated with fewer complications.
Authors and Affiliations
Banoj Kumar Ray, Prasanta Kumar Tripathy, Pramod Kumar Mohant, Pradeep Kumar Jena, Hiranya Kishor Mohanty
Keywords
Related Articles
- EP ID EP282333
- DOI 10.17511/ijpr.2017.07.02
- Views 108
- Downloads 0
Factors Affecting Peak Expiratory Flow Rates in Children of 9–12 Years of Age
Introduction: Documentation of peak expiratory flow rate (PEFR) variability may be used to support the diagnosis of asthma and other respiratory disorders. Methodology: This study was carried to measure PEFR of 510 child...
Evaluation of diagnostic role of IP-10 (Interferon Gamma Inducible Protein) and anti PGL-1 antibody in pediatric leprosy
Background: Leprosy is among the world’s oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmissio...
A study to evaluate the perinatal outcome in pregnancy induced hypertension
Introduction: Pregnancy-induced hypertension is the general classification for hypertension diseases during pregnancy, which include pregnancy-induced hypertension usually after 20th week of gestation (without proteinuri...
New born hearing screening programme at tertiary care hospital from South Karnataka-our experience
Background: Universal hearing screening is implemented in many developed countries. However, neither universal screening, nor high risk screening, exists uniformly all over India. Screening of only high risk neonates can...
Urine total glutathione levels as a potential marker of increased oxidative stress in autism
Objective: Glutathione supplement has been prescribed as a therapy in autism often without proper glutathione quantification in the body. Though, increased speech and increased imaginary play is reported, increased screa...