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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

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A nomogram for predicting choledochal cyst with perforation.

Guangwei Zhang¹, Haoming Wang¹, Jianyang Hu¹

¹Department of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Pediatric Surgery International

|May 10, 2024

Summary

This summary is machine-generated.

Early diagnosis of choledochal cyst with perforation (CC with perforation) is vital. A new nomogram, identifying key predictive factors like age and specific symptoms, aids in forecasting CC with perforation in pediatric patients.

Keywords:

Choledochal cyst Nomogram Perforation

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Area of Science:

Pediatric Surgery
Gastroenterology
Medical Diagnostics

Background:

Choledochal cyst with perforation (CC with perforation) is a rare but critical condition requiring prompt diagnosis and treatment.
Accurate forecasting of CC with perforation is essential for timely intervention and improved patient outcomes.

Purpose of the Study:

To develop and validate a predictive model for choledochal cyst with perforation.
To identify independent factors associated with the occurrence of CC with perforation.

Main Methods:

A retrospective analysis of 1111 patients who underwent surgery for choledochal cyst.
Univariate and multivariate logistic regression were used to identify predictive factors.
A nomogram was constructed and validated using ROC curves, calibration plots, and DCA.

Main Results:

The study identified age (1-3 years), elevated alanine aminotransferase, glutamyl transpeptidase, C-reactive protein, vomiting, jaundice, abdominal distension, and diarrhea as significant predictors.
The developed nomogram demonstrated excellent discriminative ability and calibration.
The nomogram showed significant clinical utility in predicting CC with perforation.

Conclusions:

The primary age group affected by choledochal cyst with perforation is 1 to 3 years old.
A validated nomogram has been established for predicting choledochal cyst perforation.
This tool can aid clinicians in the early identification of high-risk patients.