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J Surg Case Rep 2020 Jun 15;2020(6):rjaa147. Epub 2020 Jun 15.

Department of General Surgery, Hitit University Medical School, Turkey.

Extrahepatic bile duct duplication is a rare biliary anomaly often associated with conditions like cholecysto-choledocholithiasis, choledochal cyst and malignancy. Precise preoperative diagnosis using conventional radiologic imaging still remains a challenge and use of existing classification system is equally confusing. A female patient diagnosed with choledochal cyst by magnetic resonance cholangiopancreatography was found to have an associated new variant of double common bile duct during surgery. Read More

Liver Int 2020 Jun 19. Epub 2020 Jun 19.

Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Background And Aims: Patients with a choledochal malformation, formerly described as cysts, are at increased risk of developing a cholangiocarcinoma and resection is recommended. Given the low incidence of CM in western countries, the incidence in these countries is unclear. Our aim was to assess the incidence of malignancy in CM patients and to assess postoperative outcome. Read More

J Pediatr Surg 2020 May 23. Epub 2020 May 23.

Department of Paediatric Surgery, Kings College Hospital, London SE5 9RS. Electronic address:

Introduction: Type 4 choledochal malformations (CMs) can be defined as extra- and intrahepatic biliary dilatation. They are of uncertain etiology but make up about 20% of most series. The aim of this study was to investigate the pathophysiology and their natural history following surgical intervention. Read More

Surg Endosc 2020 Jun 15. Epub 2020 Jun 15.

Department of Pediatric Surgery, West China hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan, China.

Background: Little data are available to assess the learning curve for robot-assisted surgery on choledochal cysts. The aim of this current study is to investigate the characteristics of the learning curve for robot-assisted choledochal cyst excisions using the da Vinci (SI) surgical system in pediatrics.

Methods: A retrospectively collected database comprising all medical records of the first 60 consecutive patients undergoing a robot-assisted choledochal cyst excision and Roux-en-Y hepaticojejunostomy using the da Vinci (SI) surgical system performed by one individual surgeon was studied. Read More

Turk J Surg 2019 Sep 23;35(3):223-226. Epub 2019 Sep 23.

Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey.

Objectives: Choledochal cyst is a congenital disease in which surgical treatment is preliminary because of the potential for malignancy. In recent years, increase in technological developments and laparoscopic experience have popularised the use of laparoscopy in adult choledochal cyst surgery. This study aimed to present the results of eight adult patients undergoing laparoscopic choledochal excision surgery. Read More

Fetal Pediatr Pathol 2020 Jun 8:1-11. Epub 2020 Jun 8.

Pathology and Lab Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India.

: CD56 immunostain is used as an adjunct to aid in the preoperative diagnosis of biliary atresia (BA) by liver biopsy. We aimed to study the expression of CD56 in different pediatric cholestatic diseases thereby evaluating its utility in the diagnosis of BA.: We performed immunohistochemistry for CD56 on 35 cases of pediatric cholestatic diseases and five age-matched controls. Read More

Mymensingh Med J 2020 Apr;29(2):337-340

Dr Abu Saleh Md Oli Ullah, Assistant Professor, Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:

Excision of type I choledochal cyst mandates restoration of continuity of extrahepatic biliary drainage system through anastomotic options having their advantages and disadvantages. Roux en-Y Hepaticojejunostomy (RYHJ) has been very popular and long studied standard surgical treatment for type I choledochal cyst. But now Hepaticoduodenostomy (HD) is also being practiced and studied in different centers all over the world for the treatment of the same disease. Read More

Pediatr Gastroenterol Hepatol Nutr 2020 May 8;23(3):259-265. Epub 2020 May 8.

Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea.

Purpose: Perforation of choledochal cyst (CC) is a relatively rare clinical presentation in pediatric populations and difficult to predict preoperatively. We assess the clinical implications by comparing clinical parameters based on a single-center experience between perforated and nonperforated CC to facilitate the appropriate management for future interventions.

Methods: A total of 92 cases of CC in pediatric patients (aged <18 years) who received surgical management between January 2003 and December 2018 at a Pusan National University Children's Hospital were reviewed. Read More

Int J Surg Case Rep 2020 8;71:176-178. Epub 2020 May 8.

Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People's Republic of China.

Introduction: Mesothelial cyst (MC) is very uncommon in clinic, which could occasionally occur in peritoneal, retroperitoneal or even pleural cavity.

Presentation Of Case: We hereby described an infant patient with retroperitoneal MC who was misdiagnosed as congenital choledochal cyst by both radiologists and clinicians. A choledochal cyst resection with hepatojejunostomy under the da Vinci surgical system was routinely prepared for this patient but a local resection for the whole lesion was unexpectedly performed during the operation. Read More

J Int Med Res 2020 May;48(5):300060520924570

Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Here, we report a case of coexistence of a duplicate gallbladder and choledochal cyst, which was overlooked preoperatively and confirmed via intraoperative inspection and pathological examination. We concluded that a high index of suspicion is required to diagnose a double gallbladder, and special attention should be paid to preoperative radiological imaging when treating patients with choledochal cysts because these patients present a higher incidence of biliary anomalies. Read More

Ann Hepatobiliary Pancreat Surg 2020 May;24(2):228-233

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Iatrogenic pancreatic duct injury can occur during resection of the choledochal cyst (CC). We herein present a case of postoperative pancreatic fistula (POPF) developed after resection of the CC in an adult patient with variant anomalous union of pancreatobiliary duct. The 55-year-old female patient underwent surgery after the diagnosis of CC-associated gallbladder cancer. Read More

ANZ J Surg 2020 May 22. Epub 2020 May 22.

Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Melbourne, Victoria, Australia.

Int J Surg Case Rep 2020 2;70:33-36. Epub 2020 Apr 2.

Digestive System Surgery Service at Getúlio Vargas Teaching Hospital (HUGV), Avenida Apurinã, 4 - Praça 14 de Janeiro, Manaus, Amazonas, 69020-170, Brazil. Electronic address:

Introduction: Bile duct cysts are congenital malformations characterized by bile duct dilatation with intra and/or extrahepatic localization. About 80% of cases are diagnosed in childhood, so their presentation in adults is rare and repeatedly associated with complications.

Presentation Of Case: A 38-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. Read More

Surg Res Pract 2020 20;2020:8017460. Epub 2020 Apr 20.

Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India.

Background: Although choledochal cyst disease is seen predominantly in childhood, it is becomingly increasingly diagnosed in adult patients.

Methods: Data of 36 patients with choledochal cysts managed in our institute between January 2010 and December 2018 were retrospectively analyzed.

Results: Median age at presentation was 37 years (range: 13-72 years). Read More

Front Pediatr 2020 17;8:168. Epub 2020 Apr 17.

Department of General Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

Perforation of a choledochal cyst (CC) is not rare, but the pathogenesis of spontaneous perforation has not been established. Pancreaticobiliary maljunction (PBM) is commonly seen in association with choledochal cyst. To explore the relationship between PBM and perforated CC, a retrospective study was conducted. Read More

Case Rep Gastroenterol 2020 Jan-Apr;14(1):116-123. Epub 2020 Apr 2.

Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Affiliate of The Icahn School of Medicine at Mount Sinai, Brooklyn, New York, USA.

Choledochal cysts are an anatomical conundrum as they present with nonspecific symptoms generally delaying diagnosis and treatment. Its lag time remains critical, as cholangiocarcinoma, a fatal sequelae, contributes to its morbidity and mortality. Herein, we present a case of a type 1A choledochal cyst. Read More

Surg Endosc 2020 Jul 28;34(7):3223-3231. Epub 2020 Apr 28.

Department of Pediatric Surgery, West China hospital, Sichuan University, Chengdu, China.

Background: The main treatment of choledochal cysts is the complete resection of the cyst with Roux-en-Y hepaticojejunostomy, which includes open procedures, laparoscopic procedures, and robot-assisted procedures using a da Vinci surgical system. The aim of this current study was to investigate the safety and effectiveness of these three different surgical methods in pediatric choledochal cyst excisions.

Methods: Between January 2015 and December 2018, patients with choledochal cysts treated with open procedures, laparoscopic procedures, or robot-assisted procedures were retrospectively analyzed. Read More

J Pediatr Surg 2020 Mar 24. Epub 2020 Mar 24.

Department of Surgery, University of CA, San Francisco, USA. Electronic address:

Background/purpose: Choledochal cysts are congenital dilations of the bile ducts, and are associated with an increased risk of malignant transformation. The purpose of this study is to report the outcomes of a large series of patients with choledochal cysts and to highlight our analysis of one patient who developed malignancy after cyst resection.

Methods: We conducted a retrospective review of patients <18 years of age with a choledochal cyst who underwent surgical resection between 1995 and 2018. Read More

Pediatr Surg Int 2020 May 26;36(5):643-648. Epub 2020 Mar 26.

Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center Affiliated with Guangzhou Medical University, Renmin Road 318, Guangzhou, 510623, Guangdong, China.

Objective: To explore the clinical value of enhanced recovery after surgery (ERAS) with laparoscopic choledochal cyst (CDC) excision in children.

Methods: A retrospective review was performed on the clinical data from 33 in-patients whose final diagnosis was CDC. We included 18 patients who underwent the traditional treatment for CDC from April 2017 to October 2017 as the control group and 15 patients who underwent the enhanced recovery protocol (ERP) from November 2017 to May 2018 as the ERAS group. Read More

Clinics (Sao Paulo) 2020 23;75:e1539. Epub 2020 Mar 23.

Divisao de Cirurgia Pediatrica, Unidade Pediatrica de Transplante de Figado e Laboratorio de Pesquisa em Cirurgia Pediatrica (LIM 30), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Objective: To identify the best mode for diagnosing and treating the patients with choledochal cysts.

Methods: A retrospective study was performed with medical records of patients diagnosed with choledochal cysts from January 1994 to December 2017. In all cases, the diagnosis was based on ultrasound examination. Read More

J Matern Fetal Neonatal Med 2020 Mar 19:1-5. Epub 2020 Mar 19.

Children's Health, Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Infants prenatally suspected of having a choledochal cyst (CDC) typically undergo ultrasound imaging shortly after birth. This study sought to evaluate features on the initial postnatal ultrasound (IPU) that could identify newborns at risk for early complications. Following IRB approval, patients from four US fetal centers with prenatal suspicion for CDC and postnatal imaging from 2000 to 2017 were reviewed. Read More

Clin Nucl Med 2020 Jun;45(6):471-473

Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

The gallbladder is generally located at the anterolaterally situated gallbladder fossa on the undersurface of the liver, whereas choledochal cyst, as a dilation of the common bile duct, is located more posteromedially. We reported an ectopically located gallbladder, which appeared to be a choledochal cyst on hepatobiliary scintigraphy in a 10-year-old girl. Read More

Int J Surg Case Rep 2020 29;68:132-135. Epub 2020 Feb 29.

Department of Surgery, University of the West Indies, San Fernando General Hospital, San Fernando, Trinidad and Tobago; Westshore Medical Limited, Cocorite, Trinidad and Tobago.

Objective: Due to the risk of malignancy, the established management of choledochal cysts mandates bile duct excision and biliary reconstruction. While the reconstructive procedure of choice for most surgeons has traditionally been hepatico-jejunostomy, this may not be feasible in selected cases due to immobility or inadequacy of the jejunum. The following case will outline the management of a 32-year-old woman with short bowel syndrome, who was diagnosed with choledocholithiasis and a type 1 choledochal cyst. Read More

Int J Surg Case Rep 2020 19;68:111-114. Epub 2020 Feb 19.

Digestive Surgery Division of Surgery Department, Dr. Soetomo Hospital Surabaya, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo 47, Surabaya, 60132, Indonesia.

Introduction: Choledochal cyst originating from the cystic duct is a very rare case and difficult to diagnose preoperatively, it is classified as Todani type VI choledochal cyst. Only three cases of type VI choledochal cyst have been reported in the literature.

Presentation Of Case: A 35-year-old woman came with an enlarged and palpable mass in the right upper abdomen. Read More

Surg Endosc 2020 Feb 24. Epub 2020 Feb 24.

Department of Minimally Invasive Surgery, Tianjin Nankai Hospital, Nankai District, No. 122, San Wei Road, Tianjin, 300100, China.

Background: Choledochal cyst (CC)is a rare disease entity, more commonly occurring in Asian populations. In case of no contraindication, CC is resected to avoid future malignancies and future complications.

Objective: To determine the optimal technique for treatment of patients with type I choledochal cyst by comparisons of indicators, including the duration of surgery, loss of blood, rates of complication, duration of hospitalization, and outcomes of long-term follow-up. Read More

J Pediatr Surg 2020 May 12;55(5):811-820. Epub 2020 Feb 12.

Division of Pediatric Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada. Electronic address:

Purpose: This study aims to compare the prevalence and outcomes of surgically correctable congenital anomalies between sexes.

Methods: Upon registration on PROSPERO (CRD42019120165), a librarian aided in conducting a systematic review using PRISMA guidelines. The five largest relevant studies were included for each anomaly. Read More

Am J Clin Pathol 2020 May;153(6):760-771

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Objectives: Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied.

Methods: Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgically resected choledochal cysts were evaluated.

Results: Mean patient age was 23. Read More

ANZ J Surg 2020 Jun 14;90(6):1041-1045. Epub 2020 Jan 14.

Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Forme fruste choledochal cyst (FFCC), characterized by a minimally dilated common bile duct (CBD) and associated pancreaticobiliary maljunction (PBM), is difficult to diagnose in a timely manner in clinical practice. However, endoscopic retrograde cholangiopancreatography (ERCP) can clearly delineate CBD and PBM. Hence, we evaluated the value of ERCP in the diagnosis and management of FFCC. Read More

J Laparoendosc Adv Surg Tech A 2020 Mar 13;30(3):344-349. Epub 2020 Jan 13.

Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China.

This study aimed to explore the clinical efficacy of three-dimensional (3D) laparoscopic surgery in the treatment of congenital choledochal cysts (CCCs) by comparing it with two-dimensional (2D) laparoscopic surgery. We retrospectively reviewed data of 155 pediatric patients who underwent surgical treatment of choledochal cysts between January 2014 and December 2017. We divided the patients into two groups according to the surgical method used-a 3D laparoscopic group ( = 42) and a 2D laparoscopic group ( = 113). Read More

Clin Endosc 2020 Jan 8. Epub 2020 Jan 8.

Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

A lumen-apposing metal stent (LAMS) is a saddle-shaped stent with large flanges at both ends, thereby preventing stent migration and helping with approximation of the adjacent structures. We report the case of a 25-year-old female with remnant choledochal cyst which was successfully treated with LAMS after initial treatment failure with a plastic stent. Although complete excision of the cyst is the definite treatment of choledochal cysts, endoscopic ultrasonography-guided cystoduodenostomy can be considered in cases wherein surgery is not feasible and dysplasia is not present. Read More

Zhejiang Da Xue Xue Bao Yi Xue Ban 2019 Jul;48(5):474-480

The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Zhejiang Provincial Clinical Research Center for Minimally Invasive Diagnosis and Treatment of Abdominal Organs, Hangzhou 310052, China.

Objective: To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst.

Methods: One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (=65) and control group (=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups. Read More

BMJ Case Rep 2019 Dec 29;12(12). Epub 2019 Dec 29.

Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

An isolated dilatation of the cystic duct (type VI choledochal cyst (CDC)) is extremely rare with only 21 cases reported in the world literature until now. There is only one case of in situ gall bladder cancer (GBC) reported in association with type VI CDC in the literature. Here we are reporting a case of type VI CDC with papillary GBC. Read More

JGH Open 2019 Dec 22;3(6):536-539. Epub 2019 Feb 22.

Division of Surgical Gastroenterology, Department of General Surgery Postgraduate Institute of Medical Education and Research Chandigarh India.

Immunoglobulin G4 (IgG4)-related disease is a recently described autoimmune disease that can involve diverse organ systems, causing pancreatitis, cholangitis, retroperitoneal fibrosis, and thyroiditis to name a few. Key histological features include storiform fibrosis, obliterative venulitis, and intense inflammatory infiltrate composed of lymphoplasmacytic cells. The disease has a tendency to present with mass-forming lesions, often difficult to differentiate from malignant processes. Read More

Endoscopy 2020 Jun 9;52(6):E191-E192. Epub 2019 Dec 9.

Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium.

J Minim Access Surg 2020 Jul-Sep;16(3):273-275

Department of Surgical Gastroenterology and Minimal Access Surgery, Santokba Institute of Digestive Surgical Sciences (SIDSS), Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India.

The laparoscopic management of hepatobiliary pathology is an established mode of treatment. Incomplete excision of choledochal cyst with the resultant complications is a distinct surgical pathology, the treatment of which can be rendered based on the philosophy of minimally invasive approach which is now an acceptable treatment for the primary condition itself. We describe a case of hepaticojejunostomy site stricture associated with incomplete cyst excision managed laparoscopically. Read More

Rev Esp Enferm Dig 2019 12;111(12):977

Instituto Ecuatoriano de Enfermedades Digestivas .

We read with great interest the scientific letter by Sánchez Melgarejo JF et al., in which they report a degenerate Todani Ia choledochal cyst in a patient with a pancreas divisum. However, patients with a choledochal cyst might benefit from per oral cholangioscopy for malignancy detection and extension evaluation. Read More

Am Surg 2019 Nov;85(11):e539-e540

SA J Radiol 2019 10;23(1):1662. Epub 2019 Jan 10.

Department of Radiology, University of the Witwatersrand, South Africa.

Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in the paediatric age group, ranking fourth in frequency after central nervous system tumours, neuroblastomas and nephroblastomas. Embryonal RMS of the biliary tree is considered a rare entity, with the most common clinical presentation being that of obstructive jaundice. We present the case of a 4-year-old boy who presented with hepatomegaly and obstructive jaundice. Read More

Kathmandu Univ Med J (KUMJ) 2018 Oct.-Dec.;16(64):354-358

Department of Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical, Sciences (SGPGIMS), Lucknow, India.

Choledochal cyst of the cystic duct is an uncommon entity which may occur as isolated disease or may be associated with choledochal cyst of the other part of the biliary tree. In most of the reported series it was diagnosed at time of operation but now days to better investigation modality it can be diagnosed preoperatively if the index of suspicion is high. We are presenting a series of such case in pediatric age group (which includes an infant) where the diagnosis was made during operation with a light on means and ways for suspecting this entity before operation and how to differentiate other lesion with this entity with relevant review of literature. Read More

VideoGIE 2019 Oct 20;4(10):458-460. Epub 2019 Aug 20.

Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, USA.

Surg Radiol Anat 2020 Apr 9;42(4):449-452. Epub 2019 Nov 9.

Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.

The biliary tree and the pancreatic ducts originate from different buds of the primitive foregut. A plethora of anatomical variants and congenital anomalies have been described for both the biliary and the pancreatic duct systems, although they are usually asymptomatic. However, in some cases, these abnormalities can lead to serious clinical scenarios, especially when involving the biliopancreatic junction, with consequent mixing and reflux of the two different juices. Read More

Pan Afr Med J 2019 30;33:276. Epub 2019 Jul 30.

Service de Chirurgie Pédiatrique, CHU Mohamed VI, Oujda, Maroc.

Cystic malformations of the bile ducts are rare congenital disorders, with an incidence of 1/2000000 live births. Complication including the angiocholitis, chronic pancreatitis, progressive biliary cirrhosis, portal hypertension or gallbladder lithiases can reveal severe disorder. Spontaneous perforation is one of the rare complications described for the first time in 1934 by Weber. Read More

Chirurg 2020 Jan;91(1):23-28

Schwerpunkt Kinderchirurgie, Klinik für Allgemein‑, Viszeral- und Tumorchirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.

In contrast to gallstones, which are increasingly diagnosed in children and adolescents, congenital or perinatally acquired malformations of the biliary tree are rare entities. The surgical treatment of these diseases frequently represents a technical challenge. For children with biliary atresia Kasai portoenterostomy is a therapeutic option in the first weeks of life. Read More

Cureus 2019 Aug 20;11(8):e5441. Epub 2019 Aug 20.

Surgery, Dow University of Health Sciences, Karachi, PAK.

Life-threatening hemobilia is a rare cause of gastrointestinal hemorrhage. Giant choledochal cyst is also a rarely reported diagnosis. Similarly, arteriocholedochal fistulas are also rarely reported and usually occur after invasive procedures for diagnosis or treatment of hepatopancreatobiliary-related disorders. Read More

Pediatr Ann 2019 Oct;48(10):e412-e416

Meandering main pancreatic duct (MMPD) is an uncommon anomaly of the main pancreatic duct characterized by an abnormal curvature at the pancreatic head region. This variant can be diagnosed on imaging, particularly magnetic resonance cholangiopancreatography (MRCP). Although its clinical significance remains debatable, recent research suggests an association with recurrent acute pancreatitis. Read More

J Clin Ultrasound 2020 Jan 4;48(1):45-47. Epub 2019 Oct 4.

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Caroli syndrome is a developmental disorder caused by complete or partial arrest of ductal plate remodeling, leading to dilated bile ducts along with fibrosis surrounding the portal tracts. It is most commonly associated with autosomal recessive polycystic kidney (ARPKD). We report a unique case of Caroli syndrome, diagnosed prenatally at 24 weeks of gestation in a 29-year-old Thai woman. Read More

J Indian Assoc Pediatr Surg 2019 Oct-Dec;24(4):291-293

Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India.

Spontaneous perforation of choledochal cyst (CDC) is rare with an incidence of 1.8%-7%. Perforation with pseudocyst formation is even rarer, there being only two case reports. Read More

Pediatr Surg Int 2019 Dec 25;35(12):1421-1425. Epub 2019 Sep 25.

Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, 113-8421, Japan.

Aim: We compared robotic hepaticojejunostomy anastomosis (RHJA) with laparoscopic hepaticojejunostomy anastomosis (LHJA) in children undergoing complete excision of choledochal cyst.

Methods: Difficulty of suturing (DOS) during anastomosis was scored blindly, from intraoperative video recordings, using: 5 = impossible; 4 = difficult; 3 = tedious; 2 = slow; and 1 = easy. A panel of fiveindependent surgeons was also asked to compare RHJA with matched LHJA and score + 1 if RHJA appeared superior to LHJA, 0 if RHJA appeared equivalent to LHJA, and - 1 if RHJA appeared inferior to LHJA. Read More

J Laparoendosc Adv Surg Tech A 2019 Oct 20;29(10):1378-1382. Epub 2019 Sep 20.

Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.

Various studies have shown the benefit of three-dimensional (3D) systems over two-dimensional (2D) systems in endoscopic surgery. However, few studies have focused on pediatric endosurgery. The purpose of this study was to assess the impact of 2D and 3D environments on the time taken and forceps manipulation by comparing experts and trainees using a laparoscopic hepaticojejunostomy simulator. Read More