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Liem N.T.,National Hospital of Pediatrics
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2013

Laparoscopic cystectomy has become a common procedure for choledochal cysts. The cyst should be removed completely just above the confluence of the common biliopancreatic channel at the distal end and approximately 5 mm from the confluence of the right and left hepatic ducts at the proximal end to avoid complications of the cystic remnant. The operation is feasible and safe. The rate of conversion to open surgery is low. The rate of complication under skill laparoscopic surgeons is also low, even lower than in open surgery. There was no difference between hepaticoduodenostomy and hepaticojejunostomy concerning the rate of cholangitis. Gastritis due to bilious reflux occurred with a low rate in hepaticoduodenostomy. Both techniques could be used for choledochal cysts; however, hepaticoduodenostomy should be applied for choledochal cysts without intrahepatic dilatation of biliary tract. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer Japan.


Son T.N.,National Hospital of Pediatrics | Hoan V.X.,National Hospital of Pediatrics
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2013

Pyloric atresia (PA) is rare and may be associated with epidermolysis bullosa (EB). This is the first case report of a successful laparoscopic treatment of PA in a full-term 7-day-old neonate with EB. The laparoscopic approach consists of a longitudinal pyloromyotomy and excision of the thick obstructing pyloric membrane with a Heineke-Mickulicz pyloroplasty closure. Oral feeding was resumed at postoperative Day 7, and the child was discharged 5 days later with satisfactory follow-up at 8 months. Recommendations are provided for the management of the neonate with PA/EB. © 2013, Mary Ann Liebert, Inc.


Liem N.T.,National Hospital of Pediatrics | Quynh T.A.,National Hospital of Pediatrics
Journal of Pediatric Surgery | Year: 2012

Aim: The aim of this study was to describe the surgical technique and initial outcomes of laparoscopic-assisted anorectal pull-through for persistent cloaca. Materials and Methods: From January 2008 to June 2010, laparoscopic-assisted rectal pull-through was performed for 10 patients with persistent cloaca. The patient ages ranged from 3 to 9 months. The operation was carried out using 4 trocars. CO 2 pressure was maintained between 8 and 12 mm Hg. Results: Laparoscopic-assisted rectal pull-through was successfully performed in all patients. Operative time ranged from 80 to 120 minutes (mean, 91.5 ± 10 minutes). There were no intraoperative or postoperative deaths or complications. The mean hospital stay was 4.4 ± 0.5 days (range, 4-5 days). The length of follow-up varied from 6 to 24 months (mean, 12.9 ± 5.7 months) in all 10 patients. Anal stenosis was not observed in any patient. Seven patients had 1 to 2 stools per day, 2 patients had 3 stools per day, and 1 patient had 1 stool every 2 days. No patient had fecal incontinence. Conclusion: Laparoscopic rectal pull-through is a feasible, effective, and less traumatic approach for anorectoplasty in patients with persistent cloaca. © 2012 Elsevier Inc.


Liem N.T.,National Hospital of Pediatrics | Pham H.D.,National Hospital of Pediatrics | Vu H.M.,National Hospital of Pediatrics
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2011

Aim: The aim of this study was to compare the safety of laparoscopic operation with open surgery for choledochal cyst in children. Methods: Early outcomes of open surgery from January 2001 to December 2006 were compared with early outcomes of laparoscopic operations from January 2007 to July 2010. The main outcome variables included intra- and early postoperative complications, operative time, rate of reintervention, and duration of postoperative stay. Results: There were 307 patients in the open operation group and 309 patients in the laparoscopic operation group. There was no significant difference in cyst diameter between the 2 groups. The operative time was longer in the laparoscopic operation group. The number of patients requiring blood transfusion was lower in the laparoscopic operation group. Intraoperative complications were low in both groups and not significantly different. The rate of postoperative complications was lower in the laparoscopic operation group but not significantly. The rate of reintervention was significantly lower in the laparoscopic operation group. The postoperative stay was significantly shorter in the laparoscopic operation group. Conclusion: Laparoscopic operation is as safe as open operation for choledochal cyst. The postoperative stay was significantly shorter in the laparoscopic operation group. © Copyright 2011, Mary Ann Liebert, Inc.


Liem N.T.,National Hospital of Pediatrics | Dien T.M.,National Hospital of Pediatrics | Ung N.Q.,National Hospital of Pediatrics
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2010

Aim: The aim of this work was to report the technique and result of thoracoscopic repair for a newborn with congenital diaphragmatic hernia (CDH) under high-frequency oscillatory ventilation (HFOV) in the neonatal intensive care unit (NICU). Methods: Ventilation was supported by HFOV. The patient was placed in the right lateral decubitus position. Thoracoscopic surgery was performed through three 5-mm trocars. Carbon dioxide insufflation was maintained in the thoracic cavity at a pressure of 6-8 mm Hg. The hernia defect was repaired by using interrupted sutures with extracorporeal knots. Results: The operation lasted 60 minutes. The intraoperative course was uneventful. Normal vital signs and PO2 value were maintained throughout the operation. The patient had a normal chest X-ray 1 month after discharge. Conclusion: Thoracoscopic repair of CDH in the NICU during HFOV is feasible and safe. © Mary Ann Liebert, Inc.

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