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

Abstract

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