Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2018; 6(7): 143-149
Published online Jul 16, 2018. doi: 10.12998/wjcc.v6.i7.143
Robotic-assisted surgery for pediatric choledochal cyst: Case report and literature review
Xian-Qiang Wang, Shu-Juan Xu, Zheng Wang, Yuan-Hong Xiao, Jing Xu, Zhen-Dong Wang, Di-Xiang Chen
Xian-Qiang Wang, Zheng Wang, Yuan-Hong Xiao, Zhen-Dong Wang, Di-Xiang Chen, Department of Pediatrics, PLA General Hospital, Beijing 100853, China
Shu-Juan Xu, Jing Xu, Center of Anesthesia and Operation, PLA General Hospital, Beijing 100853, China
Author contributions: Wang XQ and Xu SJ contributed equally to this work, and should be considered as co-first author; Wang Z and Chen DX designed the research; Xiao YH, Wang ZD, Xu J, Wang XQ and Chen DX performed the research; Wang XQ and Xu SJ analyzed the data; Wang XQ, Xu J and Chen DX wrote the manuscript.
Supported by the PLA general hospital Clinical Support Grant, No. 2017FC-TSYS-3010.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Di-Xiang Chen, MD, PhD, Doctor, Surgeon, Department of Pediatric, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China. 301xewk@sina.com
Telephone: +86-10-66938418 Fax: +86-10-66938418
Received: February 28, 2018
Peer-review started: February 28, 2018
First decision: March 15, 2018
Revised: March 23, 2018
Accepted: April 22, 2018
Article in press: April 22, 2018
Published online: July 16, 2018
Processing time: 138 Days and 19.6 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 7-year-old female experienced abdominal pain without an obvious cause which could be self-relieved. The patient underwent imaging examination at our hospital, which indicated multiple intrahepatic and extrahepatic cystic dilatation of bile duct. It was diagnosed as type IVa congenital choledochal cysts (CCs).

Clinical diagnosis

It was clearly diagnosed as type IVa CCs.

Laboratory diagnosis

The patient underwent imaging examination at our hospital, which indicated multiple intrahepatic and extrahepatic cystic dilatation of bile duct.

Imaging diagnosis

Patient underwent an imaging examination at our hospital, which indicated multiple intrahepatic and extrahepatic cystic dilatation of bile duct.

Pathological diagnosis

The pathological examination confirmed the diagnosis of cystic dilatation of the common bile duct.

Treatment

We carried out robotic-assisted laparoscopic choledochocystectomy and biliary-intestinal anastomosis after the preoperative examinations.

Related reports

The first robotic laparoscope-assisted type I choledochocystectomy for a 5-year-old child patient in the world was reported in 2006. Subsequently, there were some related reports fellows. The Queen Mary Hospital of the University of Hong Kong in China completed the first treatment of a case of CCs with a robotic surgical system in 2013. 36 cases of children’s CCs treated by robotic surgery were reported in 2015, the largest number so far. Dr. Shaotao Tang first reported the treatment of three cases of CCs by robotic surgery in the mainland area in 2016.

Term explanation

CCs are disease of cystic dilatations of the bile duct. Its incidence in European countries and United States is 5-15 cases per million people. It is more common in Asian countries with an incidence of 1000 cases per million people.

Experiences and lessons

Choledochocystectomy for children completely by robotic surgery is safe and feasible. Our initial experience shows that this surgical approach has a clearer field than traditional endoscopy, and a more flexible operation. The surgery is more accurate and the injury is smaller. Robotic surgery may become a new trend in this surgical procedure with the advancement of technology and the accumulation of surgeons’ experience.