{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:00:43Z","timestamp":1787223643304,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T00:00:00Z","timestamp":1496707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T00:00:00Z","timestamp":1496707200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A choledochal malformation (CM) is a rare entity, especially in the Western world. We aimed to determine the incidence of CM in the Netherlands and the outcome of surgery for CM in childhood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All pediatric patients who underwent a surgical procedure for type I\u2013IV CM between 1989 and 2014 were entered into the Netherlands Study group on choledochal cyst\/malformation. Patients with type V CM were excluded from the present analysis. Symptoms, surgical details, short\u2010term (&lt;30\u00a0days) and long\u2010term (&gt;30\u00a0days) complications were studied retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between January 1989 and December 2014, 91 pediatric patients underwent surgery for CM at a median age of 2.1 years (0.0\u201317.7 years). All patients underwent resection of the extrahepatic biliary tree with restoration of the continuity via Roux\u2010en\u2010Y hepaticojejunostomy. Twelve patients (12%) were operated laparoscopically. Short\u2010term complications, mainly biliary leakage and cholangitis, occurred in 20 patients (22%), without significant correlations with weight or age at surgery or surgical approach. Long\u2010term postoperative complications were mainly cholangitis (13%) and anastomotic stricture (4%). Eight patients (9%) required radiological intervention or additional surgery. Surgery before 1 year of age (OR 9.3) and laparoscopic surgery (OR 4.4) were associated with more postoperative long\u2010term complications. We did not observe biliary malignancies during treatment or follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgery for CM carries a significant short\u2010 and long\u2010term morbidity. Given the low incidence, we would suggest that (laparoscopic) hepatobiliary surgery for CM should be performed in specialized pediatric surgical centers with a wide experience in laparoscopy and hepatobiliary surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-017-4064-x","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T13:03:55Z","timestamp":1496754235000},"page":"2631-2637","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Choledochal Malformation in Children: Lessons Learned from a Dutch National Study"],"prefix":"10.1002","volume":"41","author":[{"name":"Nederlandse Studiegroep voor Choledochus Cysten\/malformaties (NeSCHoC)","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria. H. A.","family":"van den Eijnden","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University of Groningen, University Medical Center Groningen Hanzeplein 1, HPC BA20 Postbus 30.001 9700RB Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben H. J.","family":"de Kleine","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen, University Medical Center Groningen Hanzeplein 1 9700RB Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"de Blaauw","sequence":"additional","affiliation":[{"name":"Surgery\u2010Division of Pediatric Surgery, Amalia Children\u2019s Hospital Radboud University Nijmegen, Medical Center Geert Grooteplein 10 6525GA Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G. J. M.","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen, University Medical Center Groningen Hanzeplein 1 9700RB Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart P. G.","family":"Koot","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Emma Children\u2019s Hospital, Academic Medical Center University of Amsterdam Meibergdreef 9 1105AZ Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs W. N.","family":"Oomen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Emma Children\u2019s Hospital, Academic Medical Center University of Amsterdam Meibergdreef 9 1105AZ Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius E. J.","family":"Sloots","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sophia Children\u2019s Hospital, Rotterdam, Erasmus Medical Center Erasmas University \u2018s\u2010Gravendijkwal 230 3015CE Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. G.","family":"van Gemert","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University Medical Center Maastricht University of Maastricht P. Debyelaan 25 6229HX Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"van der Zee","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University Medical Center Utrecht University of Utrecht Heidelberglaan 100 3584CX Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. W. 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