Background Numerous studies from Asian countries, including large collectives, have reported excellent results after laparoscopic resection of choledochal malformation (CM). However, the role of laparoscopic CM resection is still controversial outside Asia. We aimed to analyze the outcome of laparoscopic CM resection in our institution and to compare our outcome with the data reported in the literature.

Methods All patients who underwent laparoscopic CM resection in our pediatric surgical department from 2002 to 2019 were retrospectively analyzed for surgical details and postoperative complications, which were graded according to the Clavien–Dindo classification. A systematic literature search identified all reports on over 10 cases of laparoscopic pediatric CM resection and surgical details, follow-up, and complication rates were extracted.

Results Fifty-seven patients (72% female) with a mean age of 3.6 + 4.1 years underwent laparoscopic CM resection in our department. Conversion rate was 30%. Total complication rate was 28%. The rate of major complications (Clavien–Dindo grade III or more) was 16% and included stricture of the biliodigestive or enteric anastomosis (n = 4), adhesive ileus (n = 3), portal vein thrombosis (n = 1), and recurrent cholangitis with consecutive liver transplantation (n = 1). With increasing experience, complication rates decreased. The majority of publications on laparoscopic CM resections originated from Asia (n = 36) and reported on low complication rates. In contrast, publications originating from non-Asian countries (n = 5) reported on higher complications following laparoscopic CM resection.

Conclusion Our data indicate that laparoscopic CM resection can be safely performed. The learning curve in combination with the low incidence calls for a centralization of patients who undergo laparoscopic CM resection. There seems to be a discrepancy on complications rates reported from Asian and non-Asian countries following laparoscopic CM resection.

背景 来自亚洲国家（包括大型集体）的大量研究报告了腹腔镜胆总管畸形 (CM) 切除术后的出色结果。然而，腹腔镜 CM 切除术的作用在亚洲以外仍存在争议。我们的目的是分析我们机构的腹腔镜 CM 切除术的结果，并将我们的结果与文献中报道的数据进行比较。

方法 回顾性分析 2002 年至 2019 年在我院儿科接受腹腔镜 CM 切除术的所有患者的手术细节和术后并发症，并根据 Clavien-Dindo 分级进行分级。系统的文献检索确定了关于 10 多例腹腔镜小儿 CM 切除术的所有报告，并提取了手术细节、随访和并发症发生率。

结果 57 名平均年龄为 3.6 + 4.1 岁的患者（72% 为女性）在我们部门接受了腹腔镜 CM 切除术。转换率为 30%。总并发症发生率为 28%。主要并发症（Clavien-Dindo III 级或以上）的发生率为 16%，包括胆道或肠吻合术狭窄（n  = 4）、粘连性肠梗阻（n  = 3）、门静脉血栓形成（n  = 1）和连续肝移植复发性胆管炎（n  = 1）。随着经验的增加，并发症发生率降低。大多数关于腹腔镜 CM 切除术的出版物都来自亚洲 ( n = 36) 并报告了低并发症发生率。相比之下，来自非亚洲国家 ( n  = 5) 的出版物报告了腹腔镜 CM 切除术后更高的并发症。

结论 我们的数据表明腹腔镜 CM 切除术可以安全地进行。学习曲线与低发病率相结合，要求集中接受腹腔镜 CM 切除术的患者。腹腔镜 CM 切除术后亚洲和非亚洲国家报告的并发症发生率似乎存在差异。