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Objective <p>Operative management is the definitive treatment for congenital duodenal obstruction (CDO). Currently, there is a paucity of large-scale comparative studies on laparoscopic procedure (LP) versus open procedure (OP). This study aims to present a 10-year, single-center experience in the management of CDO in neonates from a National Children’s Hospital in China.</p> Methods <p>A single-center, retrospective cohort study with a comparative design was conducted. Neonates who underwent surgical intervention for CDO between January 2016 and July 2025 were included. To adequately adjust for baseline imbalances in gestational age and birth weight, a 1:1 propensity score matching (PSM) analysis was utilized. Differences between LP and OP in operative time, postoperative recovery, nutritional management, complication rates, and total costs were primarily compared.</p> Results <p>A total of 152 patients were enrolled and stratified into LP (<i>n</i> = 73) and OP (<i>n</i> = 79) groups. Baseline characteristics were similar except for significantly lower birth and admission weights in the OP group. After 1:1 PSM (yielding 60 pairs), operative time remained significantly longer in the LP group (median 110&#xa0;min, 95% CI 105–120 vs. 75&#xa0;min, 95% CI 69–80; <i>P</i> &lt; 0.001). Crucially, the matched LP cohort maintained significant advantages in accelerating gastrointestinal recovery and shortening postoperative parenteral nutrition (PN) duration. However, the difference in postoperative length of stay (LOS) was no longer statistically significant. Total costs showed no significant difference between the matched groups (median 25,121 RMB, 95% CI 23647–29,577 vs. 24,178 RMB, 95% CI 22385–26,268; <i>P</i> = 0.071). The overall postoperative complication rate was 5.92% with no significant intergroup difference.</p> Conclusions <p>This large-scale cohort study demonstrates that LP yields comparable overall outcomes to OP, with distinct early recovery benefits characterized by accelerated gastrointestinal recovery and a shorter PN duration. These results were achieved alongside a comparable postoperative LOS, without significantly increasing total costs or postoperative complication rates.</p> Graphical abstract <p></p>

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Management of congenital duodenal obstruction in neonates: a 10-year retrospective cohort study from a National Children’s Hospital

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Zonghan Li,
  • Zhaozhou Liu,
  • Yong Zhao,
  • Junmin Liao,
  • Shuangshuang Li,
  • Dingding Wang,
  • Kaiyun Hua,
  • Yichao Gu,
  • Yanan Zhang,
  • Xuming Liu,
  • Hezetiaili Tuersun,
  • Guangzhong Yang,
  • Jinghua Jiao,
  • Dayan Sun,
  • Jinshi Huang

摘要

Objective

Operative management is the definitive treatment for congenital duodenal obstruction (CDO). Currently, there is a paucity of large-scale comparative studies on laparoscopic procedure (LP) versus open procedure (OP). This study aims to present a 10-year, single-center experience in the management of CDO in neonates from a National Children’s Hospital in China.

Methods

A single-center, retrospective cohort study with a comparative design was conducted. Neonates who underwent surgical intervention for CDO between January 2016 and July 2025 were included. To adequately adjust for baseline imbalances in gestational age and birth weight, a 1:1 propensity score matching (PSM) analysis was utilized. Differences between LP and OP in operative time, postoperative recovery, nutritional management, complication rates, and total costs were primarily compared.

Results

A total of 152 patients were enrolled and stratified into LP (n = 73) and OP (n = 79) groups. Baseline characteristics were similar except for significantly lower birth and admission weights in the OP group. After 1:1 PSM (yielding 60 pairs), operative time remained significantly longer in the LP group (median 110 min, 95% CI 105–120 vs. 75 min, 95% CI 69–80; P < 0.001). Crucially, the matched LP cohort maintained significant advantages in accelerating gastrointestinal recovery and shortening postoperative parenteral nutrition (PN) duration. However, the difference in postoperative length of stay (LOS) was no longer statistically significant. Total costs showed no significant difference between the matched groups (median 25,121 RMB, 95% CI 23647–29,577 vs. 24,178 RMB, 95% CI 22385–26,268; P = 0.071). The overall postoperative complication rate was 5.92% with no significant intergroup difference.

Conclusions

This large-scale cohort study demonstrates that LP yields comparable overall outcomes to OP, with distinct early recovery benefits characterized by accelerated gastrointestinal recovery and a shorter PN duration. These results were achieved alongside a comparable postoperative LOS, without significantly increasing total costs or postoperative complication rates.

Graphical abstract