Letter to the Editor Comment on: Development and validation of a predictive model for bile leakage after choledochal cyst excision in children: A multicenter retrospective cohort study

jpedsurg.org

I read with interest the recent multicenter study by Ding et al.[1], which develops and externally validates a nomogram for predicting postoperative bile leakage in children undergoing choledochal cyst excision. The rigorous methodology—combining LASSO regression, bootstrap internal validation, and an independent external cohort—offers a meaningful contribution to perioperative risk stratification in pediatric biliary surgery. Several points, however, merit further discussion.

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Article · Mar 2026 · 1 min read

In brief

This letter responds to a multicenter study validating a nomogram that predicts bile leakage risk after choledochal cyst excision in children. The author acknowledges the study's rigorous LASSO regression and external validation approach while raising points for further discussion on perioperative risk stratification in pediatric biliary surgery.

Nomogram uses LASSO regression and bootstrap validation to predict bile leakage risk after choledochal cyst excision in children.
External validation in independent cohort strengthens clinical applicability for perioperative risk stratification.
Study advances evidence-based preoperative counseling and surgical planning in pediatric biliary surgery.
Rigorous multicenter methodology sets benchmark for predictive modeling in rare pediatric surgical conditions.
Tool may guide surgeon decision-making on drain placement and postoperative monitoring intensity.

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