Maria G Sacco Casamassima1, Colin Gause1, Jingyan Yang2, Seth D Goldstein1, Abhishek Swarup1, Fizan Abdullah3,4. 1. Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. 3. Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. FAbdullah@luriechildrens.org. 4. Ann & Robert H Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 63, Chicago, IL, 606011, USA. FAbdullah@luriechildrens.org.
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.
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.
Authors: C M Haberkern; L D Neumayr; E P Orringer; A N Earles; S M Robertson; D Black; M R Abboud; M Koshy; O Idowu; E P Vichinsky Journal: Blood Date: 1997-03-01 Impact factor: 22.113
Authors: J A Shea; M J Healey; J A Berlin; J R Clarke; P F Malet; R N Staroscik; J S Schwartz; S V Williams Journal: Ann Surg Date: 1996-11 Impact factor: 12.969
Authors: Patawut Bovonratwet; Matthew L Webb; Nathaniel T Ondeck; Adam M Lukasiewicz; Jonathan J Cui; Ryan P McLynn; Jonathan N Grauer Journal: Clin Orthop Relat Res Date: 2017-12 Impact factor: 4.176
Authors: Carlos Theodore Huerta; Andrew Sundin; Antoine J Ribieras; Rebecca Saberi; Walter Ramsey; Gareth Gilna; Hallie J Quiroz; Chad M Thorson; Juan E Sola; Eduardo A Perez Journal: Pediatr Surg Int Date: 2022-08-03 Impact factor: 2.003
Authors: Gileh-Gol Akhtar-Danesh; Aristithes G Doumouras; Cecily Bos; Helene Flageole; Dennis Hong Journal: JAMA Surg Date: 2018-06-01 Impact factor: 14.766
Authors: Monakshi Sawhney; Elizabeth G VanDenKerkhof; David H Goldstein; Xuejiao Wei; Genevieve Pare; Ian Mayne; Joan Tranmer Journal: BMJ Paediatr Open Date: 2021-11-23