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

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