1.Do I need to treat congenital common bile duct cyst as soon as possible? Or should I wait until the child is a little older before surgery? Congenital common bile duct cyst is a surgical disease, which can only be treated at its root through surgery, and medical treatment and Chinese medicine treatment only relieve the symptoms and treat the symptoms but not the root cause. “The earlier the better” is a principle of treating diseases, in the usual medical work, many doctors do not have a deep understanding of pediatric surgical diseases, a thousand think that pediatric surgical diseases have to wait until the child is older and then treatment will be better, do not know that many children’s death or lost the best opportunity to diagnose and treat the lifelong disability, are because of some The reason for this is that some doctors and parents always think that children are small and surgery is very traumatic, so they keep delaying it. The most direct damage organ of common bile duct cyst disease is the liver, leading to cirrhosis, liver ascites, we treat dozens of cases of cirrhotic children with common bile duct cyst every year, some have liver fibrosis grade III, and later to do surgery is useless, the liver can not recover. Cirrhosis is not difficult to appear as many parents think, on the contrary, if a child has jaundice and white stool for a month, the liver will be significantly sclerotic, and some children are able to reach grade III within a month on the degree of sclerosis. In children with asymptomatic choledochal cysts, the liver is slowly being damaged, and it is only a matter of time before the root of the disease is lifted and the liver cirrhosis occurs. Children with choledochal cysts are always at risk of choledochal cyst perforation, whether cystic or cloacal cysts, perforation may occur at any time, especially in cloacal cysts which seem to be small, but the incidence of perforation is higher. Once the choledochal cyst is perforated, the life of the child is endangered, coma and shock or even death, and once it is perforated, only open surgery is an option, and usually two operations are needed to solve the problem. Some children with perforated choledochal cysts are not obvious, but often have gastrointestinal symptoms, nausea and vomiting or abdominal pain, which can directly lead to poor diet, malnutrition, poor growth and lower height and weight than children of the same age. Therefore, early treatment is necessary. The best way to treat pediatric diseases is to go to a children’s hospital, “a line is like a mountain” works in any field, some general hospitals have a great reputation, but that is only for adult diseases, not necessarily deep knowledge of pediatric diseases. Children’s specialty hospitals have a professional understanding of pediatric diseases, and at the same time have rich clinical experience to deal with pediatric surgical diseases more professionally and effectively. Our hospital carries out more than 130 cases of radical choledochal cyst surgery every year, most of which are minimally invasive surgeries, and has accumulated a lot of systematic experience with unique surgical plans and treatment measures, which is the hospital with the most number of units and the most experience in the world, and also the hospital with the most guaranteed treatment results. On the other hand, the pediatric surgery department of the Children’s Hospital is able to prepare and safely perform surgery in a timely manner for newborns, premature babies and low birth weight babies, whether they are just one hour old. So whether your baby is a few hours, a few days, a few months, or a few years old, surgery at a specialized pediatric hospital is guaranteed. The overall incidence of choledochal cyst is very low and is a rare disease, some doctors may not see 1 case in their working lifetime, so the vast majority of large hospitals usually admit about 10 cases of children with choledochal cyst each year, and small hospitals basically do not admit. Radical choledochal cyst surgery is the highest level of pediatric surgery (level 4 surgery), and there are only a few hospitals in each province that can perform radical choledochal cyst surgery, because choledochal cysts are disseminated cases, so each hospital is not particularly experienced, and there are even fewer that can perform laparoscopic surgery. Therefore, it is important to be careful when choosing treatment to avoid the risk of transfer and secondary surgery. It is impossible to avoid the trauma of surgery for surgical diseases, and no matter when you choose to treat, you will have to go through the pain of surgery, and the later the treatment is done, the more your child will suffer, the more tortuous the road to medical treatment will be, and the more financial burden the family will have to bear. Therefore, once the choledochal cyst is diagnosed, it should be treated promptly, the sooner the better. 2.What are the advantages of minimally invasive surgery compared with ordinary surgery? ”Minimally invasive surgery has the advantages of small damage, aesthetic appearance and fast recovery of the child after surgery, but for parents, the most important concern is the efficacy. Minimally invasive laparoscopic surgery was gradually carried out in the field of pediatric surgery in the late 1990s, and after 2000 minimally invasive laparoscopic surgery became gradually popular in pediatric surgery. At present, laparoscopic minimally invasive surgery in pediatric surgery has become a worldwide trend, and 90% of the surgeries are performed through laparoscopic minimally invasive every year. The reason why laparoscopic minimally invasive surgery is so widely used is not only because of the minimally invasive damage, aesthetics and fast postoperative recovery, but also because one of the most crucial reasons is that laparoscopic minimally invasive surgery achieves or even exceeds the therapeutic effect of open surgery. In the case of choledochal cyst surgery, ordinary open surgery, because the postoperative field of view is obscured by the liver and intestinal ducts, and the surgical operation is performed in the deep position of the hepatic portal, it is often difficult to expose clearly, and the operator’s field of view is greatly restricted during the operation, which is often unfavorable, especially when performing hepatic duct jejunostomy, the most critical anastomosis site, which is extremely difficult to expose. Such problems are solved in laparotomy, where the laparoscope can flexibly and deeply probe the hepatoportal area, while the laparoscope has the function of magnification four times, so that it is very fine when separating the cyst and anastomosis anastomosis, achieving precise and detailed results, and the surgical results are naturally guaranteed. Also some blood vessels that are difficult to identify with the naked eye can be easily seen and treated in a timely manner, greatly reducing the amount of bleeding. The advantages of minimally invasive laparoscopic surgery are good surgical results, small trauma, beautiful abdominal wall, and fast recovery of the child after surgery. 3. In which cases can minimally invasive surgery be performed and in which cases cannot it be performed? Strictly speaking, all children can try minimally invasive laparoscopic surgery to give them a chance to be minimally invasive, and if during the minimally invasive surgery it is found that the operation is difficult to be completed in the abdominal cavity, it can be transferred to open surgery in time. The main factor that determines whether minimally invasive laparoscopic surgery can be performed successfully is the condition of the child itself. If the child has heavy abdominal adhesions and inflammation in the abdominal cavity, then it will be converted to open surgery under the premise of ensuring life safety. On the other hand, whether the minimally invasive surgery can be performed successfully or not is related to the parents. If the child comes to surgery when the disease is discovered, the child’s condition is relatively mild and the chance of minimally invasive surgery is greater. For children with acute perforation of the common bile duct cyst or perforation with drainage tube placed, laparoscopic minimally invasive exploration is usually possible first, and if conditions allow, then minimally invasive surgery can be performed, and if the abdominal adhesions are heavy, then open surgery will be converted. For children who have undergone surgery for choledochal cysts in outside hospitals, postoperatively due to anastomotic stenosis or atresia, open surgery is usually used. The choice of all surgical methods, i.e. whether minimally invasive treatment can be performed, is mainly determined by the condition of the child, so the earlier the treatment, especially for children with insignificant symptoms, minimally invasive surgery is the best choice and the best time for minimally invasive surgery. 4.What is the cost of minimally invasive surgery? Minimally invasive laparoscopic surgery is just an extra 1,000 yuan for the use of laparoscope on top of the open surgery fee, with no other extra charges. From hospitalization to discharge, if the recovery is smooth, all costs are routinely around 30,000. 5.Will one surgery be successful? Do I need a second surgery? If the child is critically ill or has a perforated common bile duct cyst, we usually place a bile duct drainage tube first and drain it for 1 to 3 months before performing radical surgery. For children with mild disease without special circumstances, we usually perform one surgery for radical treatment. 6.After surgery, do I need to take medication? If there is no damage to the liver (early treatment), no medication is needed after surgery. If there is damage to the liver, the duration of medication will be determined according to the damage (ranging from 1 month to 1 year). 7.How long does it take for a minimally invasive wound to return to normal? Minimally invasive wounds generally heal in 7 days after surgery, and the belly button basically returns to its original appearance after 1 month, and the wound is basically invisible 6 months after surgery. 8.What do I need to pay attention to after the surgery? Is there any attention to diet? Review: Come to our hospital for review 1 month after surgery and 6 months after surgery, after that, we can perform ultrasound and liver function examination in local hospital every year for further follow-up. Vaccination: Vaccination will be given after the liver function is completely normal after surgery. Avoid sports for 1 month after surgery, and avoid strenuous exercise for 6 months. Diet: 1 month after surgery, avoid eating raw and cold food, seafood, keep a small number of meals (2/3 of the original meal each time, 5-6 times a day to eat), and eat less greasy food (it will lead to diarrhea). After 1 month of surgery, you can eat normally, but you should not eat too much fatty meat and other fatty foods at one time. In my clinical work I found that many parents do not allow their children to eat eggs and egg yolks, and many other foods, thinking that this can avoid post-operative biliary stones, and some parents even give their children fresh water in clear soup every day, this starting point is good, but this is not scientific basis, and is not necessary, the occurrence of post-operative stones and food does not have much to do with. It takes a while to replenish the nutrition of children after surgery, and it is important to ensure their supply. Reasonable improvement of dietary structure and living habits, such as: less greasy, meat and vegetables, moderate use of animal oil, no partial consumption of animal offal, eating breakfast, drinking milk, drinking deep well water in rural areas, controlling body weight, reducing the number of pregnancies in women, drinking less alcohol, strengthening exercise, and going to bed after 22:00 hours can help prevent the occurrence of gallstone disease.