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Is there a safe advantage in performing outpatient laparoscopic cholecystectomy in children?
Keimari Méndez1, Roberto Sabater, Eduardo Chinea
1U.P.R. School of Medicine, San Juan, Puerto Rico.
Insights
Pediatric laparoscopic cholecystectomy can be safely performed as an outpatient procedure, reducing hospital stay and costs. Children with complex gallbladder issues or medical conditions may benefit from an overnight hospital stay.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Outpatient Procedures
Background:
- Laparoscopic cholecystectomy is the standard surgical procedure for pediatric gallbladder removal.
- Typically, children stay overnight following this surgery.
Purpose of the Study:
- To evaluate the safety and benefits of performing pediatric laparoscopic cholecystectomy as an outpatient procedure.
- To establish clinical criteria for identifying patients who would benefit from an inpatient stay.
Main Methods:
- A retrospective review of 35 pediatric patients undergoing laparoscopic cholecystectomy.
- Patients were divided into two groups: outpatient (Group A) and overnight stay (Group B).
- Statistical analysis was performed with significance set at P < .05.
Main Results:
- No statistically significant differences in age, sex, concomitant procedures, blood loss, or surgery duration between groups.
- Outpatient surgery (Group A) resulted in significantly shorter postoperative stays and lower medical charges.
- Patients with preoperative vomiting or associated medical conditions were more prevalent in the overnight stay group (Group B).
- No patients required hospital readmission.
Conclusions:
- Pediatric laparoscopic cholecystectomy is a safe outpatient procedure.
- Children with complicated gallbladder disease or comorbidities benefit from an overnight hospital stay.
- Outpatient surgery offers significant advantages in reduced hospital stay and medical costs.
- Effective perioperative pain management is essential for all patients.
Background:
Laparoscopic cholecystectomy, the standard procedure for removing the sick gallbladder of children, is generally performed leaving the child overnight in the hospital.
Purpose:
This study aimed to determine if there is a safe advantage in performing laparoscopic cholecystectomy as an outpatient procedure while setting the clinical parameters for those who will benefit from in-hospital stay.
Methods:
Thirty-five patients were selected for the study and were divided into group A, if the outpatient procedure was done, and group B, if the child was left overnight in the hospital. Retrospective review of medical charts was performed. Statistical significance was defined as P < .05.
Results:
Group A consisted of 13 patients and group B of 22 patients. All patients in group A left the hospital the same day of surgery. Distribution by age and sex in the groups was not statistically different. Preoperative symptoms of vomiting were statistically significantly higher in group B. Presence of an associated medical condition was higher in the in-hospital patients. Concomitant procedures, blood loss estimates, and duration of surgery showed no statistical difference. No child was readmitted after release from the hospital. Pre-, intra-, and postoperative pain management were the same in all patients. Mean postoperative stay and medical charges were statistically significant between the groups.
Conclusions:
Laparoscopic cholecystectomy can safely be done as an outpatient procedure. Children with a complicated gallbladder disease process or associated medical condition benefit from an overnight stay. Perioperative pain management is crucial in all cases. Reduced hospital stay and medical charges are significant advantages in performing laparoscopic cholecystectomy as an outpatient procedure.
