［Abstract］　Objective　To analyze the prenatal and postnatal clinical features and the prognosis of the patients with prenatally diagnosed cystic biliary atresia(CBA). Methods　The clinical data of 20 patients who were admitted to Guangzhou Women and Children′s Medical Center of Guangzhou Medical University from June 1, 2016 to June 1, 2024 and were prenatally indicated to have hepatic portal cysts by ultrasonography and were diagnosed with CBA by surgery after birth were retrospectively analyzed. The prenatal and postnatal clinical features and the prognosis of these patients were analyzed. All the patients received Kasai′s procedure after birth. The patients were divided into type Ⅰ CBA group(9 patients) and type Ⅲ CBA group(11 patients) according to their intraoperative angiography results. The clinical features and prognosis were compared between the two groups. Results　In the 20 patients with prenatally diagnosed CBA, the median value of gestational age at which hepatic portal cysts were detected by the first prenatal ultrasonography in them was 24.00(20.00, 24.75)weeks. The median age of the patients receiving operations after birth was 43.00(30.75, 57.25)days. The incidence of postoperative cholangitis was 55.00%(11/20). The jaundice clearance rate at 3 months after operation was 73.68%(14/19). The continuous jaundice clearance rate was 75.00%(12/16). The survival rate of autologous liver was 66.67%(10/15). The liver transplantation rate was 20.00%(3/15). The mortality rate was 13.33%(2/15). The maximum diameter of the cysts measured by the first prenatal ultrasonography in the type Ⅰ CBA group was significantly larger than that in the type Ⅲ CBA group(P<0.05). There were no statistically significant differences between the two groups in terms of the patients′ basic information, the last biochemical indicators before operation, the operation-related indicators, the postoperative pathological results, the postoperative hospital stay and the prognosis(P>0.05). Conclusion　The patients with prenatally diagnosed CBA can obtain early treatment after birth and may have a better prognosis. There are no significant differences in postnatal clinical features and postoperative outcomes between the pediatric patients with type Ⅰ CBA and those with type Ⅲ CBA.]]> 2025/7/4 11:15:38 1, HUANG Lin², HOU Longlong¹, WANG Junjie¹, YU Jiakang¹, ZHONG Wei¹]]> GUAN Xisi¹, HUANG Lin², HOU Longlong¹, WANG Junjie¹, YU Jiakang¹, ZHONG Wei¹ 6true ［Abstract］　Objective　To compare the clinical efficacy of uni-port and traditional three-port thoracoscopy or laparoscopy in treating pediatric extralobar pulmonary sequestration(EPS) and to provide evidence for optimizing surgical approaches. Methods　A retrospective analysis was conducted on the clinical data of 107 pediatric patients with EPS diagnosed by surgery and pathology in Capital Center for Children′s Health, Capital Medical University from January 2017 to January 2025. The pediatric patients were divided into uni-port group(20 patients) and three-port group(87 patients) according to different surgical procedures received by the pediatric patients. The indicators including baseline data, operation time, intraoperative blood loss, postoperative length of hospital stay, usage rate of analgesics and complications were compared between the two groups to analyze and evaluate the safety and efficacy of the two surgical procedures. Results　The operation time and the postoperative length of hospital stay in the uni-port group were significantly shorter than those in the three-port group(P<0.05). On the day after operation, the proportion of the pediatric patients who took oral analgesics in the uni-port group was lower than that in the three-port group(P<0.05). There were no patients converted to thoracotomy in either group, and there were no intraoperative blood transfusions and serious complications. In the three-port group, 1 patient had wound infection and 1 patient had rib injury after operation. In the uni-port group, there were no patients with the corresponding complications. There was no statistically significant difference in the incidence of complications between the two groups(P>0.05). Conclusion　Uni-port thoracoscopy or laparoscopy is safe and effective in treatment of pediatric EPS. Compared with the traditional three-port endoscopic surgical procedure, the uni-port endoscopic surgical procedure has the advantages of shorter operation time, faster postoperative recovery, less pain and satisfactory cosmetic outcome of incision. The uni-port endoscopic surgical procedure can be promoted as the preferred surgical procedure, but a comprehensive decision needs to be made in combination with the surgeons′ experience and the individual condition of the pediatric patients.]]> 2025/7/4 11:15:38 WU Yurui, ZHENG Qipeng, CAO Zhenhua, CHEN Meng, ZHANG Hua, ZHOU Yan, LI Zexi, SU Yun, LIU Jing 5true ［Abstract］　Objective　To explore the feasibility and safety of total single-incision laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy(TSILH) for the treatment of congenital choledochal cysts in pediatric patients. Methods　A retrospective analysis was conducted on the clinical data of 97 pediatric patients who underwent single-incision laparoscopic-related operations in Guizhou Branch of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from January 2018 to March 2023. According to surgical procedures, the pediatric patients were divided into TSILH group(n=41), and single-incision laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy(SILH) group(n=56). The intraoperative and postoperative indicators and the incidence of complications were compared between the two groups. Results　The operations in all the pediatric patients were successfully completed under laparoscopy, without conversion to laparotomy or conventional multi-port laparoscopic surgery. The operation time in the TSILH group［(195.60±13.75)min］ was longer than that in the SILH group［(173.20±34.38)min］, and the time for end-to-side jejunal anastomosis during the operation in the TSILH group［(65.75±8.02)min］ was also longer than that in the SILH group［(36.88±5.43)min］, with statistically significant differences between the two groups(P<0.05). There were no statistically significant differences between the two groups in terms of intraoperative blood loss, time for resuming diet after operation, time to remove the abdominal drainage tube, length of hospital stay after operation, and the incidence of complications(P>0.05). Conclusion　TSILH is a safe and feasible treatment for pediatric congenital choledochal cysts, with good outcomes and satisfactory incisions. However, the overall operation time is relatively prolonged, and it requires a high level of laparoscopic anastomosis skill in the surgeons.]]> 2025/7/4 11:15:38 ZHOU Zhou, ZHUANG Yize, ZHANG Jie, LUO Miao, LI Fei, FAN Xia, HUANG Huang, QIN Zhijie, TANG Yingming 4true ［Abstract］　Objective　To evaluate the effectiveness of applying the concept of enhanced recovery after surgery(ERAS) in perioperative period of pediatric congenital choledochal cysts. Methods　A retrospective analysis was conducted on the clinical data of 103 pediatric patients with congenital choledochal cysts who were admitted to Department of Pediatric Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region from March 2015 to December 2023. According to whether the concept of ERAS was applied to these patients, they were divided into control group(58 patients) and observation group(45 patients). Both groups underwent laparoscopic radical surgery for choledochal cysts. The control group was managed according to traditional surgical concept and the observation group was managed according to ERAS concept in the perioperative period. The clinical and laboratory indicators during and after the operation were compared between the two groups. Results　There were no statistically significant differences in gender, age, weight, preoperative white blood cell count(WBC), C-reactive protein(CRP), hemoglobin(Hb), albumin(ALB) and prealbumin(PAB) between the two groups(P>0.05). The levels of WBC and CRP at 24 hours after operation and the level of CRP at 3 days after operation in the observation group were significantly lower than those in the control group(P<0.05). There were no statistically significant differences in the level of Hb at 24 hours after operation and in the levels of WBC and Hb at 3 days after operation between the two groups(P>0.05). There were no statistically significant differences in the levels of WBC, CRP, Hb, ALB and PAB at 2 weeks after operation between the two groups(P>0.05). The pediatric patients in both groups were cured and discharged from the hospital. None of these patients were readmitted to hospital within 30 days after the operation. There were no significant differences in the duration of operation and intraoperative blood loss between the two groups(P>0.05). Compared with the pediatric patients in the control group, the pediatric patients in the observation group had earlier recovery time of bowel sounds and shorter hospital stay after operation, and less hospitalization expenses, with statistically significant differences(P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05). The satisfaction rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion　The application of the ERAS concept is safe, effective and feasible in the perioperative period of pediatric congenital choledochal cysts. It has clinical application value and is worthy of further research and promotion in clinical practice.]]> 2025/7/4 0:00:00 WANG Wenmei, DENG Hongqiang, XIONG Quanqing, YANG Bowen, XIE Danlu, LI Liqin, WU Ling, PAN Yun, LIU Xing, ZHAO Qi 3true ［Abstract］　Objective　To discuss the experience in diagnosis and treatment of intercurrent cavernous transformation of the portal vein(CTPV) after surgery for congenital choledochal cyst(CCC) in children combining literature review. Methods　The clinical data and postoperative follow-up results of 2 children with intercurrent CTPV after surgery for CCC who were admitted to Hunan Children′s Hospital were retrospectively analyzed, and the relevant literature was summarized and analyzed. Results　Case 1: female, 6 years and 9 months old,undergoing radical surgery for CCC in another hospital more than 4 years ago. Case 2: female, 11 years and 7 months old, undergoing radical surgery for CCC in another hospital more than 10 years ago. The two children were diagnosed with CTPV following an emergency admission due to gastrointestinal bleeding. Intraoperative angiography indicated occlusion of the main portal vein in the two children, and the “main protal vein-left portal vein shunt(MPV-LPV)” was performed on them. The portal vein pressure after the operation decreased to the normal range in the two children. The two children were followed up for one year after the operation. The bypass vessels were unobstructed and there were no complications such as gastrointestinal bleeding in them. A total of 8 patients with intercurrent CTPV after surgery for CCC were included in combination with literature review. Among them, 2 patients received MPV-LPV, 3 patients received left gastric vein-left portal vein bypass(LGV-LPV) procedure, 2 patients received Roux-Y jejunal vein-left portal vein bypass(RYV-LPV) procedure, and 1 patient received percutaneous transhepatic angioplasty. After postoperative follow-up, 7 patients had unobstructed shunt vessels, and 1 patient had shunt vessel occlusion. Conclusion　CTPV is a rare complication after surgery for CCC. During the radical surgery for CCC, attention should be paid to protecting the portal vein to reduce the risk of injury. Once symptoms such as gastrointestinal bleeding and hypersplenism occur, it is recommended to choose Rex shunt as the first option to restore the blood flow from the portal vein to the liver.]]> 2025/7/4 11:15:38 1,2, YIN Qiang², PENG Yuming², JI Chunyi², CHEN Lijian², XIE Weixin²]]> LIAO Siqi^1,2, YIN Qiang², PENG Yuming², JI Chunyi², CHEN Lijian², XIE Weixin² 2true ［Abstract］　Objective　To observe the application effect of Child Life Specialist in enhanced recovery after surgery(ERAS) after laparoscopic appendectomy in children. Methods　A total of 208 pediatric patients with acute appendicitis who underwent laparoscopic appendectomy in Affiliated Hospital of Zunyi Medical University from November 2021 to November 2024 were included in this study. These patients were divided into control group(n=105) and observation group(n=103) according to random number table method. The control group was given traditional routine nursing intervention. The observation group received a special medical pattern of Child Life Specialist on the basis of the traditional routine nursing intervention. The pediatric patients′ anxiety scores and their family members′ anxiety scores were compared between the two groups by using modified Yale Preoperative Anxiety Scale-Short Form(mYPAS-SF) and State Anxiety Inventory(S-AI) before and after the interventions. The degrees of postoperative pain of the pediatric patients in the two groups were evaluated by using Wong-Baker FACES Pain Rating Scale(WBS) and Visual Analogue Scale(VAS). The ERAS-related indicators and satisfaction degrees of the pediatric patients′ family members were compared between the two groups. Results　The pediatric patients′ anxiety scores and their family members′ anxiety scores after interventions, and the pain scores at 6 hours, 12 hours and 24 hours after operation in the observation group were lower than those in the control group, with statistically significant differences between the two groups(P<0.05). After the operation, the time to first anal exhaust in the observation group was earlier than that in the control group［(16.01±2.33)h vs (19.70±3.76)h］, and the time to first food intake in the observation group was earlier than that in the control group［(17.44±2.33)h vs (21.03±3.85)h］. The length of hospital stay in the observation group was shorter than that in the control group ［(6.18±0.79)d vs (8.47±2.44)d］. The satisfaction degree scores of the pediatric patients′ family members in the observation group were higher than those in the control group［(98.04±1.26)points vs (93.30±2.46)points］. There were significant differences in the above indicators between the two groups(P<0.05). There was no statistically significant difference in the incidence of the pediatric patients′ postoperative complications between the two groups(P>0.05). Conclusion　The application effect of Child Life Specialist is significantly effective in ERAS for the pediatric patients undergoing laparoscopic appendectomy. It can effectively reduce the anxiety levels of the pediatric patients and their family members, alleviate the postoperative pain of the pediatric patients, promote the postoperative anal exhaust of the pediatric patients, shorten the time to first food intake and the length of hospital stay of the pediatric patients, and improve the satisfaction degrees of the pediatric patients′ family members.]]> 2025/7/4 0:00:00 ZHAO Qing, CHANG Li, TAN Xianqun, JIN Zhu, ZHENG Zebing 1true