Initial experience of single-incision laparoscopic hepaticojejunostomy using conventional instruments for correctable biliary atresia

J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):615-20. doi: 10.1089/lap.2011.0518. Epub 2012 Jun 12.

Abstract

Background/purpose: Single-incision laparoscopic surgery aims to minimize surgical trauma. Yet there has been no report on its application to the treatment of correctable biliary atresia (BA). We present here our initial mini-series of successful single-incision laparoscopic hepaticojejunostomy (SILH) for correctable BA.

Patients and methods: We reviewed 4 correctable BA patients (Type I/II, 3/1) who underwent SILH between May and July 2011. Ultrasonography, upper gastrointestinal contrast studies, and blood tests were performed during the follow-up period. The age at operation, operative time, postoperative hospital stay, resumption of full diet, postoperative complications, and perioperative laboratory tests were evaluated.

Results: The median age at operation was 21 days. The median operative time was 2 hours. Blood loss was minimal. The median follow-up duration was 4.5 months. Jaundice gradually declined after 3-5 days in Type I and 6 days in Type II BA patient. There was no mortality or surgical complication so far.

Conclusions: In experienced hands, SILH for treatment of correctable BA is safe and effective.

MeSH terms

  • Biliary Atresia / surgery*
  • Biliary Tract Surgical Procedures / methods*
  • Female
  • Humans
  • Infant, Newborn
  • Jejunostomy / methods*
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Liver Function Tests
  • Male
  • Operative Time
  • Postoperative Complications / epidemiology
  • Treatment Outcome