Laparoscopy to Remove Gall Bladder Cyst
The surgeries were performed in two girls aged 3 and 4 by a team in the Surgery Department headed by Prof. Naftali Freud, in collaboration with Dr. Jurgen Schleif, internationally renowned specialist in minimal invasive surgery procedures, and a team of anesthetists, headed by Dr. Yakov Katz.
A choledochal cyst is a congenital defect appearing in 1:150000 infants in the western world and three times more common in females. Most children are diagnosed before the age of 10 with key symptoms of pain in the abdomen, palpable abdominal mass and jaundice. In most cases, the cyst is shown in an ultrasound of the abdomen. Other tests may be done such as an MRI, CT, bile duct catheterization or endoscopy. Sometimes the cyst is diagnosed only when an infection occurs in the biliary ducts, and in 1-10% of such cases, fissures in the cyst cause a severe and dangerous abdominal infection. The risk of infection increases with time alongside the danger of the cyst becoming malignant, and therefore surgery is recommended for removal of the cyst during childhood.
Over the years, several types of surgery have been performed but unless the cyst is removed in its entirety, morbidity is significantly raised including the possibility of developing a malignant tumor in the cyst residue. Accepted treatment today is therefore total excision of both the cyst and the bile ducts, and restoration of the distal bile ducts (biliary reconstruction) by creating an outlet from the liver to the digestive system, in most cases to the small intestine in a procedure called hepaticojejunostomy.
The operation is conducted through laparoscopy whereby 4 small incisions of 5-12mm are made on the abdominal surface instead of the traditional incision of 12cm or more. The advantages of laparoscopy include a quicker recovery, reduced danger of complications connected to the surgical incision, and aesthetics of the resultant scarring.
Prof. Freud stated that “the Department of Child and Adolescent Surgery at Schneider is one of the pioneers of laparoscopy in Israel, and as time progresses, more and more operations are conducted utilizing this advantageous technique for the benefit of our young patients.”