Background
Congenital biliary dilatation (CBD) is a rare malformation in the development of the biliary duct. Since 1990, there have been significant advancements in CBD research and substantial changes in treatment methods. This study aims to identify and evaluate global trends in CBD research over the past 30 years, as well as visualize research hotspots and potential frontiers through bibliometric analysis.
Methods
This study conducted a comprehensive search of CBD articles published from January 1990 to December 2022 in the Web of Science Core Collection database. Visual analysis was performed on the countries, research institutions, authors, keywords, and research frontiers included in the articles using CiteSpace and VOSviewer software.
Results
A total of 1794 articles were published, and the overall number of articles showed an upward trend. The United States, Japan, and China are the top three countries in terms of article output. Juntendo University has the highest number of publications. Li Long, Miyano Takeshi, and Cheng Wei are the top three researchers in terms of publication volume. Co-occurrence analysis of keywords shows that "choledochal cyst", "management", and "children" are the three most important keywords. Keyword co-occurrence forms 19 clusters, and burst citation analysis (2013–2022) identifies 13 cutting-edge keywords. CBD research hotspots mainly focus on diagnosis, minimally invasive surgery, and carcinoma.
Conclusions
This study employs bibliometric analysis to examine the literature on CBD from 1990 to 2022, revealing the development and changes in the field of CBD, identifying three main research hotspots, and exploring potential research frontiers. The findings of this study offer valuable references for researchers in the field of CBD.
Purpose This study aimed to evaluate the factors associated with constipation and the efficacy of the distal resection length (DRL) of not less than 3cm in males with anorectal malformation (ARM).
Methods Demographic, associated anomalies, clinical features, and the bowel function of the males with ARM and rectourethral/rectovesical fistula (RUF/RVF) were evaluated. The Krickenbeck scores were used to assess bowel function. Univariate and multivariate analysis were used to identify factors associated with constipation. The bowel function was evaluated between the groups categorized by DRL after 1:1 propensity score matching (PSM).
Result A total of 153 males with a median follow-up period of 6 years, 54(35.2%) suffered from constipation. Multivariate analysis revealed that the DRL (OR = 0.68, P = 0.007) is the only independent protective factor of constipation after potty training. After PSM, 35 patients were included in each of the groups categorized by DRL≥3.0cm and DRL<3cm, and the patients were well-balanced. No significant differences between groups were noted in postoperative complications (11.4% vs. 25.7% P = 0.218) and constant soiling (17.1% vs. 31.4%, P = 0.718). However, the incidence of constipation in the DRL≥3.0cm group was significantly lower than that in the DRL<3cm group(37.1% vs. 71.4%, P = 0.028).
Conclusion The longer distal resection was the independent protective factor for constipation, suggesting that the excessive preservation of the rectal pouch is the cause of constipation. And the constipation rate in ARM with DRL ≥3cm was significantly lower without increment of soiling after PSM, which may be associated with the fibrosis in the last 3cm of the rectal pouch. Thus, not less than 3cm of the rectal pouch is recommended to resect in males with ARM.
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