{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:00:28Z","timestamp":1787169628240,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the feasibility, safety, and efficacy of laparoscopic excision of choledochal cysts (CDCs) with Roux-en-Y hepaticojejunostomy (HJ) in pediatric patients at a tertiary care teaching institution in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective review of electronic medical records from November 2019 to November 2024, involving 43 children who underwent laparoscopic CDC excision with Roux-en-Y HJ in a single surgical unit. Data collected included demographic information, clinical presentation, imaging features, CDC classification, preoperative interventions, surgical details, postoperative complications, and follow-up outcomes. Laparoscopic HJ was performed by a single surgeon with a four-port technique with extracorporeal jejunojejunostomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The cohort consisted of 43 children (26 girls), with a mean age of 5.5 (0.33\u201317) years and a mean weight of 16.5 (6\u201348) kg, including seven infants. Preoperative interventions were required in 11 (25.6%) children. The mean operative time was 406 (315\u2013545) min, with an 11.6% conversion rate to open surgery due to difficult anatomy. Postoperative complications were observed in 34.8% of patients, primarily minor (Clavien\u2013Dindo Grade I or II), including bile leak in 6.9% of patients, managed without further intervention. Major complications included adhesive obstruction and anastomotic stricture, requiring reoperations in two patients. The mean time to full enteral feeds was 6.5 (4\u20139.5) days, and the mean hospital stay was 9.3 (5\u201325) days. Follow-up (mean duration: 27.2 months) showed no intrahepatic biliary radical dilation or recurrent cholangitis or pancreatitis, with normal liver function tests in all patients except one who developed liver decompensation and was lost to follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Laparoscopic excision of CDC with Roux-en-Y HJ in children is a safe, feasible, and effective approach, offering numerous benefits while presenting manageable risks and complications. With advancements in minimally invasive techniques and increased surgeon expertise, this method holds promise for becoming a widely adopted standard in pediatric surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_17_25","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T08:00:23Z","timestamp":1744963223000},"page":"497-507","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Laparoscopic Excision of Choledochal Cysts with Roux-en-Y Hepaticojejunostomy in Children: Surgical Technique, Experience, and Outcomes"],"prefix":"10.4103","volume":"30","author":[{"given":"Ankur","family":"Mandelia","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pujana","family":"Kanneganti","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwani","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prathibha B.","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moinak Sen","family":"Sarma","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshu","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujjal","family":"Poddar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajanikant R.","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Khuba","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"R1-20250704","doi-asserted-by":"crossref","first-page":"3223","DOI":"10.1007\/s00464-020-07560-1","article-title":"Comparison of pediatric choledochal cyst excisions with open procedures, laparoscopic procedures and robot-assisted procedures: A retrospective study","volume":"34","author":"Xie","year":"2020","journal-title":"Surg 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outcomes following total robotic and total laparoscopic Roux-en Y hepaticojejunostomy for choledochal cyst in paediatric population: A preliminary report from a tertiary referral centre","volume":"39","author":"Pawar","year":"2023","journal-title":"Pediatr Surg Int"},{"key":"R12-20250704","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4103\/jiaps.JIAPS_150_20","article-title":"Modified laparoscopic excision of choledochal cyst: Technique and early results","volume":"26","author":"Pandey","year":"2021","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R13-20250704","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s00383-005-1596-1","article-title":"Laparoscopic management of pediatric choledochal cysts in developing countries: Review of ten cases","volume":"22","author":"Srimurthy","year":"2006","journal-title":"Pediatr Surg 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response to surgery: The overlooked aspect?","volume":"30","author":"Sugandhi","year":"2014","journal-title":"Pediatr Surg Int"},{"key":"R24-20250704","doi-asserted-by":"crossref","first-page":"3910","DOI":"10.1007\/s00464-015-4697-5","article-title":"Recurrence of biliary tract obstructions after primary laparoscopic hepaticojejunostomy in children with choledochal cysts","volume":"30","author":"Diao","year":"2016","journal-title":"Surg Endosc"},{"key":"R25-20250704","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1089\/lap.2019.0026","article-title":"Laparoscopic management of choledochal cysts associated with aberrant hepatic ducts","volume":"29","author":"Wen","year":"2019","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R26-20250704","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1007\/s00464-019-06807-w","article-title":"Laparoscopic management for aberrant hepatic duct in children with choledochal cysts","volume":"33","author":"Diao","year":"2019","journal-title":"Surg Endosc"},{"key":"R27-20250704","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/ases.12358","article-title":"Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Can stenosis of the hilar hepatic duct affect postoperative outcome?","volume":"10","author":"Miyano","year":"2017","journal-title":"Asian J Endosc Surg"},{"key":"R28-20250704","doi-asserted-by":"crossref","first-page":"e022162","DOI":"10.1136\/bmjopen-2018-022162","article-title":"Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: A retrospective case study in Southeast China","volume":"8","author":"Guo","year":"2018","journal-title":"BMJ Open"},{"key":"R29-20250704","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s00464-014-3667-7","article-title":"Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China: A multicenter study","volume":"29","author":"Qiao","year":"2015","journal-title":"Surg 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