Purpose
The establishment of enteral feeding is the end point of any intestinal anastomosis. This study examined the effects of early feeding (EF) as compared to delayed feeding (DF) on postoperative outcomes after intestinal anastomosis in children.
Methods
This was a randomized controlled pilot study to assess the effect of EF vs. DF in terms of time to reach full feed, along with wound infection and anastomotic leak.
Results
Twenty-eight patients were enrolled in both study groups. The median time to first feed in EF was 60 hours and 96 hours in DF. The median time to first bowel sound was 42 hours in EF and 48 hours in DF (p=0.208). The median time to first bowel movement was 72 hours in EF and 72 in DF (p=0.820). The median time of postoperative hospital stay was 5.5 days in EF and 6.0 days in DF (p=0.01). There was no significant difference in complications of wound infection, wound dehiscence, relook surgery, or anastomotic leak in both groups.
Conclusion
EF after intestinal anastomosis is safe and feasible in children after intestinal anastomosis.

Citations

• Modified Enhanced Recovery After Surgery Protocols in Pediatric Gastric Transposition: Effects on Recovery and Outcomes
  Mohit B. Chauhan, Nitin James Peters, Muneer Abas Malik, Shivani Dogra, Ravi Prakash Kanojia, Rajni Sharma, Sandhya Yaddanapudi, Monika Bawa, Shailesh Solanki, Jai Kumar Mahajan
  Journal of Indian Association of Pediatric Surgeons.2026; 31(1): 20.     CrossRef
• Early vs. delayed feeding after pediatric gastrointestinal surgery: a systematic review and meta-analysis
  Mohammed Al Blooshi
  Pediatric Surgery International.2026;[Epub]     CrossRef
• Nutritional Timing in Pediatric Stoma Reversal: Early Versus Late Feeding Practices
  Nadia Shoukat, Mumtaz Ahmed Qureshi, Ali Hasham, Sadia Shoukat, Nazia Azam Yousfani, . Matiullah
  Biological and Clinical Sciences Research Journal.2025; 6(9): 85.     CrossRef

Purpose
Biliary atresia (BA) is a rare but progressive cholangiopathy and the leading cause of pediatric liver transplantation worldwide. The Korean Association of Pediatric Surgeons (KAPS) has conducted three national surveys (2001, 2011, and 2023) to assess long-term trends in the diagnosis, treatment, and outcomes of BA. This study provides a comparative analysis of the 2nd and 3rd national surveys, with reference to selected findings from the 1st survey.
Methods
This study included 453 patients from the 3rd national survey (2011–2021) and 435 patients from the 2nd survey (2001–2010), all of whom underwent Kasai portoenterostomy. Data were collected via electronic case report forms from pediatric surgical centers nationwide. Comparisons were made regarding demographics, clinical features, diagnostic patterns, operative details, follow-up outcomes, and survival. Kaplan–Meier analysis was used to evaluate long-term survival.
Results
The mean number of BA patients per year remained stable between surveys (43.5 in the 2nd, 41.18 in the 3rd), though centralization of care increased, with 61.5% of cases managed by two major institutions in the 3rd survey. The median age at surgery decreased, and the use of preoperative imaging (especially magnetic resonance cholangiopancreatography) increased. The 10-year native liver survival rate declined from 59.8% to 53.7%, while overall 10-year survival improved slightly (92.9% to 93.2%). Postoperative complications, such as cholangitis and liver failure, persisted but were better categorized. The 3rd survey also reported improved mortality (4.9%) and reduced follow-up loss (11.5%) compared to the 2nd survey.
Conclusion
While overall survival after Kasai operation has remained high and even improved, native liver survival has slightly declined. The findings reflect earlier diagnosis, more consistent diagnostic imaging, and increasing centralization of care. These trends underscore the importance of long-term nationwide data collection in guiding future strategies for BA management in Korea.

Citations

• Long-Term Outcomes of Biliary Atresia in Korea: A Nationwide Multicenter Cohort Study (2012–2021)
  Kyong Ihn, Ki Hoon Kim, Soo-Hong Kim, Hae-Young Kim, Hyun-Young Kim, Younghyun Na, Jung-Man Namgoong, So Hyun Nam, Junbeom Park, Jinyoung Park, Taejin Park, Joonhyuk Son, Hyun Beak Shin, Joohyun Sim, Hee-Beom Yang, Chaeyoun Oh, Hyun Ji Woo, Joong Kee Youn
  Journal of Pediatric Surgery.2026; : 163501.     CrossRef

A ciliated foregut cyst is a rare developmental anomaly. It develops from the primitive foregut. It is usually located supra-diaphragmatically. Its localization in the gallbladder is very infrequent and has been sparsely reported. We report a rare case of a ciliated cyst of the gallbladder in an 11-year-old female, who presented with complaints of upper abdominal pain for 2 months. She was suspected to have gallbladder duplication or gallbladder diverticulum on imaging. The histopathology reported this anomaly as a ciliated foregut cyst. The ciliated cyst of the gallbladder is a benign congenital lesion. Abdominal ultrasonogram and computed tomography/magnetic resonance imaging are suggestive of a cystic lesion of the gallbladder. The definitive diagnosis is by histopathological examination. This is a rare clinicopathological condition in the pediatric age group. The recommended treatment is laparoscopic cholecystectomy. The role of conservative management has not been established due to the rarity of the condition.

Citations

• Fundic Gallbladder Diverticulum Lesion in a Child Suspected to Be Congenital: A Case Report and Scoping Review
  Samentha Menager, Piero Farruggia, Salvatore Calderaro, Domenico Bivona, Giovanni Francesco Saia, Marco Guida, Antonino Levita, Chiara Marino, Federica Mescolo, Tiziana Guida Rutilio, Michelangelo Giovanni Sciortino, Barbara Torrente, Flavia Volpe, Giovan
  Pediatric Reports.2026; 18(5): 117.     CrossRef

Purpose
This study aimed to evaluate postoperative outpatient follow-up practices among pediatric surgeons in Korea for five common congenital diseases: esophageal atresia with tracheoesophageal fistula (EA/TEF), anorectal malformation (ARM), Hirschsprung’s disease (HSCR), choledochal cyst (CC), and inguinal hernia (IH).
Methods
A web-based survey consisting of 43 questions was distributed to members of the Korean Association of Pediatric Surgeons. The survey assessed the timing, frequency, and duration of outpatient follow-up, as well as disease-specific practices.
Results
Of 154 invited surgeons, 45 (29.2%) responded. Most scheduled the first follow-up visit within one week after discharge. During the first postoperative year, follow-up visits were commonly held every three months, followed by six months or annual intervals. Most surgeons concluded follow-up before age 18; however, 15.6%–37.8% reported continuing follow-up into adulthood depending on the disease. Variation was observed in disease-specific practices: 44.4% routinely performed contrast studies for EA/TEF follow-up; sizes #14–15 Hegar dilators were most used in ARM; only 6.7% performed routine rectal irrigation in HSCR. For CC, 88.9% checked both blood tests and ultrasonography. Most IH patients received only one follow-up visit.
Conclusion
While early postoperative follow-up practices among pediatric surgeons in Korea appear relatively consistent, wide variation exists in long-term strategies and disease-specific protocols. This reflects the tendency to rely on individual clinical judgment and highlights the need for standardized, national consensus.

Citations

• Transition of Care to Late Adolescent/Adults in Paediatric Surgery: Perspectives From Indian Paediatric Surgeons
  Sunita Singh, Yogesh Kumar Sarin, Subhashis Saha, Mukesh Shukla
  Journal of Indian Association of Pediatric Surgeons.2026; 31(4): 541.     CrossRef

Purpose
Most patients with perinatally detected subhepatic cysts receive information suggestive of a suspected diagnosis of choledochal cyst (CC). However, it is not uncommon to be finally diagnosed with cystic biliary atresia (CBA), a disease with a more unfavorable prognosis. This study aimed to investigate the distribution of the final diagnoses of perinatally detected subhepatic cysts and to compare patients diagnosed with CC and CBA.
Method
We performed a retrospective review of patients with subhepatic cysts detected using ultrasonography during perinatal period, between January 2012 and December 2022.
Result
This retrospective study included 52 patients with perinatal subhepatic cysts. Of these, 71.2% (37/52) were diagnosed with CC, 15.4% (8/52) with CBA, and 5.8% (3/52) with duplication of the alimentary tract. Only 1.9% (1/52) of the patients were diagnosed with biliary atresia, gallbladder duplication, mesenteric lymphatic malformation, or were normal. Of all patients, 86.5% (45/52) were diagnosed with CC or CBA, with CBA accounting for 17.8% (8/45). There were no statistically significant differences between the CC and CBA groups regarding the gestational age at which the cyst was first detected and the final size of the cyst measured on prenatal ultrasound.
Conclusion
Subhepatic cysts detected during the perinatal period are typically diagnosed as CC. However, this study revealed that 15.4% of all patients were diagnosed with CBA, despite no significant differences in prenatal ultrasound findings. Therefore, it is essential to consider the possibility of CBA in cases of perinatally detected subhepatic cysts.

Citations

• Prenatal Diagnosis of Isolated Caroli Disease Caused by a Homozygous PKHD1 Variant: A Case Report and Literature Review
  Hai Wang, Zitong Xu, Xianjue Zheng, Haojie Pan, Yimin Wang, Haiying Chen, Zhenzhen Zheng, Hongping Zhang, Jiayong Zheng
  Clinical and Experimental Obstetrics & Gynecology.2026;[Epub]     CrossRef