Background To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results All 55 patients (TLH = 30, CLH = 25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57 ± 0.19 d and 4.56 ± 0.27 d, respectively (t = 3.07, P < 0.01), the postoperative hospital stay was 5.50 ± 0.28 d and 7.00 ± 0.74 d (t = 2.03, P < 0.05), and the hospitalization expenses were CNY 40,085 ± 2447 and CNY 26,084 ± 2776 (t = 3.79, P < 0.001). There were no significant differences in intraoperative blood loss (9.57 ± 3.28 ml vs 8.2 ± 1.13 ml, t = 0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5 ± 2.46 min vs 75.00 ± 2.04 min, t = 1.68, P = 0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, χ2 = 0.07, P = 0.79). Conclusions TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.

The purpose of this article is to report the status of the efficacy of and long-term adherence to the Bowel Management Program (BMP) for fecal incontinence (FI) postoperation in China.Children over 3 years of age with FI postoperation referred to our medical center were included in the study. Evaluations were performed before and 2 years after their clinic visit. The cost of bowel care, improvement in incontinence, health-related quality of life, and family functioning with the BMP were analyzed.A total of 48 children with FI were included in our study, of whom 38 were boys. The median treatment fee was 660.1 dollars. The complications included abdominal pain (4 patients, 8%), occasional vomiting (2 patients, 4%), and hypoglycemia (1 patient, 2%). The incontinence status and health-related quality of life improved significantly after the BMP. Despite the good outcome of the BMP, half of the patients discontinued the program.The BMP is an effective approach to manage FI and improve the patients’ quality of life. Poor long-term adherence is currently the main challenge affecting the BMP application in China.

Biliary atresia (BA) is a genetic and severe fibro-inflammatory obliterative cholangiopathy of neonates. Platelet-derived growth factor subunit A (PDGFA), as one of participants in liver fibrosis, the overexpression of PDGFA through DNA hypomethylation may lead to the development of BA, but the pathogenesis is still unclear. We conducted a large case-control cohort to investigate the association of genetic variants in PDGFA with BA susceptibility in the Southern Chinese population (506 cases and 1473 controls). We observed that the G allele of rs9690350(G&gt;C) in PDGFA was significantly associated with an increased risk of BA (OR=1.24, 95% CI=1.04-1.49, P=0.02). Additionally, the rs9690350 G allele increased the risk of non-cystic biliary atresia (OR=1.26, 95% CI=1.04-1.52, P=0.02) and was a genetic biomarker of severe manifestations after surgery. These findings indicate that the rs9690350 G allele is a PDGFA polymorphism associated with the risk of BA that may confer increased disease susceptibility.

Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively ( t =3.07, P <0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d ( t =2.03, P <0.05), and the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 ( t =3.79, P <0.001). There were no significant differences in intraoperative blood loss (9.57±3.28 ml vs 8.2±1.13 ml, t =0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t =1.68, P =0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, c ² =0.07, P =0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.

BackgroundTo investigate the clinical characteristics of gastric duplication (GD) in children.MethodsThe clinical data of 17 children with GD who were treated in our hospital from July 2015 to June 2021 were analyzed retrospectively. There were 8 males and 9 females, aged from 2 months to 11 years. All children underwent laparoscopic GD resections and postoperative pathological diagnosis was GD. In addition, we searched and analyzed the literature on GD in children from 1 January 2011 to 31 December 2021 from the PubMed, EMBASE, and Cochrane Library databases.ResultsGastric duplication was more common in females, with the most common cystic type occurring in the greater curvature of the stomach. Vomiting is the most common clinical manifestation. Ultrasound is an effective method for the early screening of GD. In this study, one patient who had multiple GDs underwent laparoscopic cystectomy and mucosectomy, one patient was converted to open surgery, and all other children underwent laparoscopic cystectomies. The time to oral intake was 2.3 ± 1.0 days (range: 1–4 days), and the postoperative hospital stay was 5.7 ± 1.7 days (range: 2–9 days). All children were followed up for 6–77 months and had an uneventful recovery with the resolution of the preoperative symptoms.ConclusionGastric duplication in children lacks specific clinical manifestations, and the preoperative diagnosis rate is not high, so surgical exploration combined with pathological examination is often needed to make a clear diagnosis. Laparoscopic cystectomy can achieve good therapeutic results.