Risk factors for complications after laparoscopic surgery in children with congenital choledochal cysts

Background: Laparoscopic Roux‑en‑Y hepaticojejunostomy is the standard treatment for pediatric congenital choledochal cysts (CCCs). However, postoperative complications remain a significant clinical challenge. This study aimed to identify independent risk factors and develop a predictive model for complications following laparoscopic CCC excision in children. Methods: We conducted a retrospective cohort study of 362 pediatric patients who underwent laparoscopic surgery for CCC between August 2019 and July 2024 at two tertiary centers. Preoperative variables were systematically collected. Univariable and multivariable logistic regression analyses identified predictors of complications, with significant variables (P5 mm [odds ratio (OR) =4.23, 95% confidence interval (CI): 1.26-6.75; P5 mm, chronic cholecystitis, Todani Type I, elevated CRP, and elevated DB were selected as factors to assess the prognosis of children with choledochal cysts, providing important reference value for the prognostic evaluation and clinical management of children with choledochal cysts.