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National Trends in Interventions for Pediatric Gallstone Pancreatitis

Audra J Reiter1,2, Lynn Huang2, Yao Tian2

  • 1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 8, 2023
PubMed

Insights

Laparoscopic cholecystectomy (LC) rates for pediatric gallstone pancreatitis remained stable over two decades. However, interventions like LC and ERCP are happening earlier, leading to shorter hospital stays for children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Health Services Research

Background:

  • Laparoscopic cholecystectomy (LC) is standard for adult gallstone pancreatitis during the initial hospital stay.
  • Trends in managing pediatric gallstone pancreatitis, specifically the use of LC and endoscopic retrograde cholangiopancreatography (ERCP), require evaluation.

Purpose of the Study:

  • To assess the trends in the utilization of LC and ERCP for pediatric patients diagnosed with gallstone pancreatitis.
  • To analyze changes in the timing of these interventions and their impact on hospital length of stay (LOS).

Main Methods:

  • A retrospective cohort study utilizing the Kids' Inpatient Database (2000-2019).
  • Inclusion criteria: patients aged 18 or younger with a primary diagnosis of gallstone pancreatitis.
  • Statistical analysis included the Mann-Kendall trend test to evaluate temporal trends.

Main Results:

  • The overall rate of LC during the index hospitalization for pediatric gallstone pancreatitis remained consistent (55.4% to 63.8%).
  • Interventions, including LC and ERCP, occurred earlier in the hospitalization, with average hospital days decreasing significantly for LC (4.6 to 3.4).
  • Average length of stay (LOS) decreased for patients undergoing LC (6.8 to 5.1 days) and for those not undergoing procedures (5.7 to 4.0 days).

Conclusions:

  • The proportion of LC performed during the index hospitalization for pediatric gallstone pancreatitis has been stable over the past 20 years.
  • Interventions for pediatric gallstone pancreatitis are trending towards earlier administration within the hospital stay.
  • These earlier interventions are associated with a reduction in overall hospital length of stay for affected children.

Keywords:
gallstone pancreatitislaparoscopic cholecystectomypediatric surgery

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