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Same day discharge after laparoscopic cholecystectomy in children.
Brian G A Dalton1, Katherine W Gonzalez1, Erol Marty Knott1
1Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
The Journal of Surgical Research
|March 16, 2015
Summary
Same day discharge (SDD) after laparoscopic cholecystectomy (LC) for gallstones and biliary dyskinesia is safe in children. This approach reduces hospital stays without increasing complications, with staff comfort improving over time.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Limited data exist on same day discharge (SDD) safety for pediatric laparoscopic cholecystectomy (LC).
- Adult data support SDD for symptomatic cholelithiasis (SC) and biliary dyskinesia (BD).
Purpose of the Study:
- To analyze the initial experience with a new SDD protocol for pediatric LC.
- To evaluate the safety and efficacy of SDD in children undergoing LC for SC and BD.
Main Methods:
- Retrospective chart review of 227 pediatric LC cases from January 2011 to July 2014.
- Comparison of outcomes between the SDD group (n=57) and overnight stay (ONS) group (n=170).
Main Results:
- No significant differences in complication rates or readmissions between SDD and ONS groups.
- SDD group had a significantly shorter length of stay.
- Obstacles to SDD included late surgery times and clinical habits, which improved with protocol experience.
Conclusions:
- SDD is a safe option for pediatric patients undergoing LC for SC or BD.
- Addressing surgical timing and clinical practices can increase SDD rates.
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