{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:36:54Z","timestamp":1773995814762,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["\u4e0d\u300282271743"],"award-info":[{"award-number":["\u4e0d\u300282271743"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["\u7f16\u53f782071682"],"award-info":[{"award-number":["\u7f16\u53f782071682"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012620","name":"Taishan Scholar Foundation of Shandong Province","doi-asserted-by":"publisher","award":["\u5956\u9879\u7f16\u53f7 TSTP 20221155"],"award-info":[{"award-number":["\u5956\u9879\u7f16\u53f7 TSTP 20221155"]}],"id":[{"id":"10.13039\/100012620","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["\u4e0d\u3002ZR2022MH276"],"award-info":[{"award-number":["\u4e0d\u3002ZR2022MH276"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["\u4e0d\u3002ZR2021MH210"],"award-info":[{"award-number":["\u4e0d\u3002ZR2021MH210"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["\u4e0dZR2021MH334"],"award-info":[{"award-number":["\u4e0dZR2021MH334"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital choledochal cysts (CCC) are rare biliary anomalies associated with significant morbidity. The impact of preoperative nutritional status on surgical outcomes in pediatric CCC patients remains unclear. This study aimed to investigate this relationship, using a validated nutritional risk screening tool to stratify patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of pediatric patients who underwent CCC excision with Roux-en-Y hepaticojejunostomy at a single center between January 2011 and September 2025. Nutritional risk was assessed within 24\u2005h of admission using the Screening Tool for Risk on Nutritional Status and Growth (STRONG\n                      <jats:sub>kids<\/jats:sub>\n                      ). Patients were categorized into moderate malnutrition risk group (MR) and high malnutrition risk group (HR). Propensity score matching (PSM) was employed to balance baseline characteristics. Perioperative outcomes were compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 208 included patients, 107 were stratified as HR and 101 as MR before PSM. After PSM, 91 matched pairs were analyzed. The HR group had significantly lower weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age z-scores (BAZ), along with lower preoperative hemoglobin, albumin, total protein, and higher bilirubin and GGT levels. Postoperatively, the HR group experienced longer abdominal drainage duration, delayed gastrointestinal recovery, higher inflammatory markers (WBC, CRP), worse liver function markers, and lower albumin and lymphocyte counts. The overall complication rate was significantly higher in the HR group, primarily driven by a greater incidence of cholangitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Preoperative high nutritional risk, identified by the STRONG\n                      <jats:sub>kids<\/jats:sub>\n                      screening tool, is strongly associated with adverse perioperative outcomes in children undergoing CCC surgery. Routine nutritional screening may facilitate risk stratification and guide preoperative optimization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1773325","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:23:15Z","timestamp":1773984195000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative nutritional risk and adverse perioperative outcomes in children with congenital choledochal cysts: a retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaoyang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiamin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jichang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiongqian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiwu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.hpb.2022.09.010","article-title":"Diagnosis and management of choledochal cysts","volume":"25","author":"Brown","year":"2023","journal-title":"HPB (Oxford)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1007\/s00383-017-4083-6","article-title":"Pediatric choledochal cysts: diagnosis and current management","volume":"33","author":"Soares","year":"2017","journal-title":"Pediatr Surg 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