A multicenter retrospective analysis by the Korean association of pediatric surgeons comparing laparoscopic and open surgical repair of congenital duodenal obstruction

Background: This multicenter retrospective study aimed to compare key perioperative outcomes such as operative time, time to full enteral feeding, hospital stay duration, postoperative complications, and mortality, between laparoscopic and open surgical repair of congenital duodenal obstruction (CDO) performed by members of the Korean Association of Pediatric Surgeons (KAPS). Methods: A national survey conducted between 2021 and 2023 provided data from 75 patients. Demographic characteristics, associated anomalies, anatomical types, surgical approach, and postoperative outcomes were compared between the laparoscopic (n = 36) and open (n = 39) groups. Results: Among the 75 patients (30 males, 45 females; male-to-female ratio 1:1.5), no significant differences were observed between groups in sex, birth weight, or gestational age. Surgical procedures included 66 duodenoduodenostomies, four duodenojejunostomies, two gastrojejunostomies, two web excisions with duodenoplasty, and one segmental duodenal resection. Laparoscopic repair was associated with longer operative times (p = 0.005). Time to full enteral feeding was comparable in both groups (p = 0.117). Hospital stay was significantly shorter in the laparoscopic group (p = 0.012). Postoperative complications and mortality did not differ between groups; no deaths occurred. Conclusion: Laparoscopic repair can be considered a safe and effective alternative to open surgery for selected patients with CDO, assuming adequate surgical expertise.