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Safety of outpatient laparoscopic cholecystectomy in children: analysis of 2050 elective ACS NSQIP-pediatric cases

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Abstract

Purpose

Limited data exists evaluating the extent of utilization and safety of outpatient laparoscopic cholecystectomy (LC) in children. The aim of this study was to investigate the safety of outpatient LC in the pediatric population utilizing a national surgical quality improvement database.

Methods

The National Surgical Quality Improvement Program-Pediatric (NSQIP-P) databases from 2012 and 2013 were queried to identify pediatric patients who underwent elective LC. Patients who underwent outpatient LC were compared with those who underwent inpatient LC. Outcomes of interest included 30-day overall morbidity, readmission, and reoperation.

Results

A total of 2,050 LC were identified, 995 (48.5 %) were performed as an outpatient procedure and 1055 (51.5 %) as inpatient. Patients who underwent outpatient LC were more often white (79.6 vs. 69.2 %; p = <0.0001). Choledocholithiasis was more often treated in inpatient setting (12.5 vs. 1.7 %; p < 0.0001), while biliary dyskinesia was performed in outpatient setting (26.1 v. 12.6 %; p = 0.0001). Overall 30-day morbidity was greater in the inpatient group (2.5 vs. 0.8 %; p = 0.03). There were no differences in term of 30-day readmission rate and related reoperations (0.9 vs 0.3 % respectively; p = 0.09).

Conclusion

This analysis of a large multicenter dataset demonstrates that pediatric patients without significant associated comorbidities can safely undergo laparoscopic cholecystectomy as an outpatient procedure.

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References

  1. Mariette C, Pessaux P (2011) Ambulatory laparoscopic fundoplication for gastroesophageal reflux disease: a systematic review. Surg Endosc 25:2859–2864

    Article  PubMed  Google Scholar 

  2. Tang H, Dong A, Yan L (2015) Day surgery versus overnight stay laparoscopic cholecystectomy: a systematic review and meta-analysis. Dig Liver Dis 47(7):556–561

    Article  PubMed  Google Scholar 

  3. Gurusamy KS, Junnarkar S, Farouk M et al (2008) Day-case versus overnight stay for laparoscopic cholecystectomy. Cochrane Data Syst Rev (3):CD006798. doi:10.1002/14651858.CD006798.pub3

  4. Jawaheer G, Evans K, Marcus R (2013) Day-case laparoscopic cholecystectomy in childhood: outcomes from a clinical care pathway. Eur J Pediatr Surg 23:57–62

    Article  PubMed  Google Scholar 

  5. Dalton BG, Gonzalez KW, Knott EM et al (2015) Same day discharge after laparoscopic cholecystectomy in children. J Surg Res 195:418–421

    Article  PubMed  Google Scholar 

  6. Agarwal P, Bagdi RK (2014) Day case laparoscopic cholecystectomy in children: a review of 11 cases. J Indian Assoc Pediatr Surg 19:61–64

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mendez K, Sabater R, Chinea E et al (2007) Is there a safe advantage in performing outpatient laparoscopic cholecystectomy in children? J Pediatr Surg 42:1333–1336

    Article  PubMed  Google Scholar 

  8. Walker SK, Maki AC, Cannon RM et al (2013) Etiology and incidence of pediatric gallbladder disease. Surgery 154:927–933

    Article  PubMed  Google Scholar 

  9. Mehta S, Lopez ME, Chumpitazi BP et al (2012) Clinical characteristics and risk factors for symptomatic pediatric gallbladder disease. Pediatrics 129:e82–e88

    Article  PubMed  Google Scholar 

  10. Langballe KO, Bardram L (2014) Cholecystectomy in Danish children—a nationwide study. J Pediatr Surg 49:626–630

    Article  PubMed  Google Scholar 

  11. Knott EM, Fike FB, Gasior AC et al (2013) Multi-institutional analysis of long-term symptom resolution after cholecystectomy for biliary dyskinesia in children. Pediatr Surg, Int

    Google Scholar 

  12. Khoo AK, Cartwright R, Berry S et al (2014) Cholecystectomy in english children: evidence of an epidemic (1997–2012). J Pediatr Surg 49:284–288 (discussion 288)

  13. Akoh JA, Watson WA, Bourne TP (2011) Day case laparoscopic cholecystectomy: reducing the admission rate. Int J Surg 9:63–67

    Article  PubMed  Google Scholar 

  14. Richardson WS, Fuhrman GS, Burch E et al (2001) Outpatient laparoscopic cholecystectomy. Outcomes of 847 planned procedures. Surg Endosc 15:193–195

    Article  CAS  PubMed  Google Scholar 

  15. Mjaland O, Raeder J, Aasboe V et al (1997) Outpatient laparoscopic cholecystectomy. Br J Surg 84:958–961

    Article  CAS  PubMed  Google Scholar 

  16. Voyles CR, Berch BR (1997) Selection criteria for laparoscopic cholecystectomy in an ambulatory care setting. Surg Endosc 11:1145–1146

    Article  CAS  PubMed  Google Scholar 

  17. Fleming WR, Michell I, Douglas M (2000) Audit of outpatient laparoscopic cholecystectomy. Universities of Melbourne HPB Group. Aust N Z J Surg 70:423–427

  18. Robinson TN, Biffl WL, Moore EE et al (2002) Predicting failure of outpatient laparoscopic cholecystectomy. Am J Surg 184:515–518 (discussion 518-9)

  19. Johansson M, Thune A, Nelvin L et al (2006) Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy. Br J Surg 93:40–45

    Article  CAS  PubMed  Google Scholar 

  20. Raval MV, Lautz TB, Browne M (2011) Bile duct injuries during pediatric laparoscopic cholecystectomy: a national perspective. J Laparoendosc Adv Surg Tech A 21:113–118

    Article  PubMed  Google Scholar 

  21. Kelley-Quon LI, Dokey A, Jen HC et al (2014) Complications of pediatric cholecystectomy: impact from hospital experience and use of cholangiography. J Am Coll Surg 218:73–81

    Article  PubMed  Google Scholar 

  22. Haberkern CM, Neumayr LD, Orringer EP et al (1997) Cholecystectomy in sickle cell anemia patients: perioperative outcome of 364 cases from the National Preoperative Transfusion Study. Preoperative Transfusion in Sickle Cell Disease Study Group. Blood 89:1533–1542

    CAS  PubMed  Google Scholar 

  23. Hyder O, Yaster M, Bateman BT et al (2013) Surgical procedures and outcomes among children with sickle cell disease. Anesth Analg 117:1192–1196

    Article  PubMed  Google Scholar 

  24. Shea JA, Healey MJ, Berlin JA et al (1996) Mortality and complications associated with laparoscopic cholecystectomy, A meta-analysis. Ann Surg 224:609–620

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Lau H, Brooks DC (2001) Predictive factors for unanticipated admissions after ambulatory laparoscopic cholecystectomy. Arch Surg 136:1150–1153

    Article  CAS  PubMed  Google Scholar 

  26. Tannuri AC, Leal AJ, Velhote MC et al (2012) Management of gallstone disease in children: a new protocol based on the experience of a single center. J Pediatr Surg 47:2033–2038

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Maria G. Sacco Casamassima, Colin Gause, Seth D. Goldstein, Abhishek Swarup & Fizan Abdullah

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Jingyan Yang

  3. Ann & Robert H Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Box 63, Chicago, IL, 606011, USA

    Fizan Abdullah

Authors
  1. Maria G. Sacco Casamassima
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  2. Colin Gause
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  3. Jingyan Yang
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  4. Seth D. Goldstein
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  5. Abhishek Swarup
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  6. Fizan Abdullah
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Correspondence to Fizan Abdullah.

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Sacco Casamassima, M.G., Gause, C., Yang, J. et al. Safety of outpatient laparoscopic cholecystectomy in children: analysis of 2050 elective ACS NSQIP-pediatric cases. Pediatr Surg Int 32, 541–551 (2016). https://doi.org/10.1007/s00383-016-3888-z

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  • DOI: https://doi.org/10.1007/s00383-016-3888-z

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