Abstract: Objective To explore the risk factors associated with the development of cholangitis following laparoscopic surgery for pediatric congenital choledochal cysts, and to provide preventive a framework to help reduce the incidence of postoperative cholangitis. Methods Eighty-five children diagnosed with congenital choledochal cysts who underwent laparoscopic surgery at our hospital from June 2018 to June 2022 were included in the study. Based on the occurrence of postoperative cholangitis, participants were divided into two groups: a concurrent group (n=14) and a non-concurrent group (n=71). Differences in clinical characteristics between the two groups were compared. Univariate and multivariate Logistic regression analyses were used to evaluate the risk factors for cholangitis following laparoscopic surgery for congenital choledochal cysts in children. Results In the concurrent group, the proportions of anemia, biliary calculi, cyst diameter>5cm, preoperative albumin ≤ 30g/L, intraoperative bleeding>60ml, and preoperative total bilirubin>1.7 μmol/L was 64.28%, 78.57%, 71.43%, 71.43%, 78.57%, 85.71% respectively, which were significantly higher than those in the non-concurrent group( 28.17%, 40.85%, 30.99%, 42.25%, 45.07%, 35.21%, respectively)(all P<0.05); Multivariate logistic regression analysis confirmed that anemia, biliary calculi, cyst diameter>5cm, preoperative albumin ≤ 30g/L, intraoperative bleeding>60ml, and preoperative total bilirubin>1.7 μ mol/L were risk factors for cholangitis after laparoscopic surgery for congenital choledochal cyst in children(P<0.05). Conclusion The incidence of cholangitis following laparoscopic surgery for congenital choledochal cyst in children is significantly associated with factors such as anemia, cyst diameter, intraoperative bleeding, presence of biliary calculus, preoperative albumin levels, and preoperative total bilirubin levels.

Key words: Congenital choledochal cyst in children, Laparoscopic surgery, Cholangitis, Single factor analysis, Multifactor analysis