Timing of minimally invasive surgery for neonates with congenital cystic dilatation

Objective To explore the timing and method of laparoscopic surgery for newborns with congenital cystic dilatation. Methods One hundred and forty nine 0-12 months old children with congenital cystic dilatation treated by laparoscopic surgery at our center from December, 2011 to December, 2018 were selected, and were divided in a newborn group (age < 28 days), a small infant group (28 days ≤ age < 90 days), and a big infant group (90 days ≤ age ≤12 months). The operation time, relative bleeding volume during operation, postoperative complications, hospitalization time, and liver function before operation were compared among these 3 groups. According to the postoperative pathological results, the incidences of inflammation and cirrhosis were compared. Results There were no statistical differences in the operation time among these 3 groups (P>0.05). The bleeding volume of the big infant group was statistically different from those of the rest two groups (P 0.05). The incidences of obstructive jaundice, complications, and cirrhosis were 75.6%, 7.3%, and 17.1% in the newborn group, which were higher than those in the infant group (all P<0.05). The incidencea of choledochal calculus and inflammation were higher in the big infant group than in the rest two groups (P<0.05). Conclusion Early surgery for neonates with choledochal cyst may reduce the incidences of obstructive jaundice, choledochal inflammation, choledochal calculus, and cirrhosis. If the technical conditions permit, laparoscopic choledochal cyst resection should be performed in infancy, so as to lower the incidence of postoperative complications. Laparoscopic choledochal cyst resection and Roux-Y hepaticojejunostomy in treatment of infancy congenital cystic dilatation have a good effect. Key words: Laparoscopic surgery; Neonates; Congenital cystic dilatation; Cirrhosis; Prenatal diagnosis