Day case laparoscopic cholecystectomy in children: A review of 11 cases

Agarwal, Prakash; Bagdi, Raj Kishore

doi:10.4103/0971-9261.129593

Cited by 7 publications

(5 citation statements)

References 8 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This outcome could be attributed to the careful patient selection in our protocol, which specifically targeted individuals with an ASA score of 1, no language barriers, and proximity to the hospital. Consistent with the growing trend of ERAS in pediatric surgery, our results show the feasibility and safe application of this approach for pediatric gallbladder lithiasis, resulting in a low complication rate and outpatient discharge rates comparable to the current literature [11][12][13][14][15][16].…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Enhanced Recovery after Surgery Applied to Pediatric Laparoscopic Cholecystectomy for Simple Cholelithiasis: Feasibility and Teaching Insights

Pio,

Tulelli,

Ali

et al. 2023

Children

View full text Add to dashboard Cite

Background: Same-day discharge after a cholecystectomy is a common practice in the adult population and has been demonstrated as safe and viable for children as well. However, there is a lack of comprehensive teaching models for pediatric cholecystectomy. Drawing inspiration from standardized outpatient procedures, this study aimed to assess the clinical outcomes and feasibility of teaching programs and an Enhanced Recovery After Surgery (ERAS) protocol following ambulatory laparoscopic cholecystectomy in pediatric patients. Methods: In 2015, an ERAS pathway for laparoscopic cholecystectomy (LC) was implemented, focusing on admission procedures, surgery timing, anesthetic choices, analgesia, postoperative feeding, mobilization, and pain assessment. Day-case surgery was not applicable for acute cholecystitis, choledochal lithiasis, sickle cell disease, and hereditary spherocytosis cases. The protocol was employed for a group of attending surgeons and fellows, as well as a group of residents under the supervision of experienced surgeons. A retrospective analysis was conducted to evaluate the feasibility and effectiveness of ambulatory cholecystectomy in children and its utilization in training pediatric surgical trainees. Results: Between 2015 and 2020, a total of 33 patients were included from a cohort of 162 children who underwent LC, with 15 children operated on by senior surgeons and 18 by young surgeons. The primary diagnoses were symptomatic gallbladder lithiasis (n = 32) and biliary dyskinesia (n = 1). The median age at the time of surgery was 11.3 years (interquartile range (IQR) 4.9–18), and the median duration of surgery was 54 min (IQR 13–145). One intraoperative complication occurred, involving gallbladder rupture and the dissemination of lithiasis into the peritoneal cavity. Three patients (9%) required an overnight stay, while no postoperative complications or readmissions within 30 days were observed. ERAS was successfully implemented in 30 patients (91%). No significant differences in surgical outcomes were noted between senior and young surgeons. At an average follow-up of 55 months, no long-term sequelae were identified. Conclusions: These findings align with the current trend of increasing use of outpatient laparoscopic cholecystectomy and underscore its feasibility in the pediatric population. The application of a structured ERAS protocol appears viable and practical for training the next generation of pediatric surgeons. Level of Evidence: Level III.

show abstract

Section: Discussionsupporting

confidence: 89%

“…Furthermore, recent years have seen the emergence of ERAS protocols specifically designed for LC in children, with studies reporting excellent results. These advancements underscore the importance of tailoring approaches to the unique needs and characteristics of the pediatric population [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Enhanced Recovery after Surgery Applied to Pediatric Laparoscopic Cholecystectomy for Simple Cholelithiasis: Feasibility and Teaching Insights

Pio,

Tulelli,

Ali

et al. 2023

Children

View full text Add to dashboard Cite

show abstract

“…operating time of laparoscopic cholecystectomy in our study was 42 minutes (range 30-65min) at par with other series 18,23 . Proper pain management and wound care are the two most important goals of postoperative management 24 .…”

Section: Meansupporting

confidence: 52%

Paediatric cholelithiasis: our experience at a tertiary care centre

Thakur

Hasan

Rahul

et al. 2021

Sri Lanka J Child Health

View full text Add to dashboard Cite

Background: With increased incidence of symptomatic and asymptomatic gallstones in children, paediatric cholelithiasis has emerged as an important pathology in children. A retrospective study evaluates paediatric cholelithiasis and its management at a tertiary centre. Objectives:To study the spectrum of paediatric cholelithiasis and its management issues.Method: A retrospective study was conducted at a tertiary care on all patients of paediatric cholelithiasis (children less than 14 years) who were managed from April, 2017 to March, 2020. Data regarding demographic profile, clinical history, investigation results, management and postoperative outcomes were collected and analysed.Results: Of the 52 ultrasound-confirmed cases of gallstones, 35 showed biliary and dyspeptic symptoms; while 17 were asymptomatic. Males outnumbered females; no child less than three years came with gallstones. No definite aetiology was found in 32 cases. Cholecystectomy was done in 40 patients (laparoscopic in 37 cases, open in three cases). Stone analysis revealed mixed stones (thirty cases), pigment stones (eight cases) and pure cholesterol stones (two cases). 10/17 cases of asymptomatic gallstones showed complete stone resolution from gallbladder on follow-up sonogram after six months; 5/17 showed no regression of stones (one symptomatic and rest four underwent elective surgery due to parental anxiety); 2/17 cases were lost to follow up. No major complication was seen.

show abstract

“…Due to the retrospective nature of our study, we refrained from commenting on anatomic variations as there may have been lacking information about anatomy in operative notes. Previous history of cholecystitis may also contribute to the Oral feeding, postoperative nausea: Although overnight nasogastric drainage was previously favored, we find it unnecessary to keep drainage catheters postoperatively in cases without comorbidities (10,19). In a study of short-term postoperative evaluation of complaints in adults, authors detected a severe postoperative nausea and vomiting (PONV) at a rate of 2% (20).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Same-Day Discharge Following Laparoscopic Cholecystectomy in Children

Dökümcü¹,

Divarcı²,

Tiryaki³

et al. 2017

jpr

View full text Add to dashboard Cite

ABS TRACTÖz Aim: Laparoscopic cholecystectomy (LC) as day surgery is widely performed on adults; however, experience in pediatric LC in an out-patient setting is limited. We aimed to review our experience and investigate related factors. Materials and Methods: Medical records of patients who underwent elective LC from June 2005 to July 2016 were retrospectively reviewed. Patients were grouped according to the duration of hospital stay, and patient characteristics and outcome were compared. T-test and chi-square were used for statistical analysis. Results: A hundred and sixty-seven patients with a mean age of 10.4 years were enrolled. There was no conversion to open surgery, with only one postoperative complication in a patient with consumption coagulopathy. Same-day discharge (SDD), overnight stay (ONS) and prolonged stay (PS) groups were constituted of 50, 92, 25 patients respectively. All groups had similar preoperative characteristics and median postoperative pain scores. Previous history of cholecystitis and underlying hematological diseases were more common in the PS group (p<0.05). Duration of anesthesia was shortest in SDD, longest in PS groups (p<0.006). Perioperative minor complications were more common in the PS group than the SDD group (p=0.03). Mean time for oral feeding was 3.2, 5.4 and 14.8 hours for SDD, ONS and PS groups respectively (p<0.009). There was no readmission. Conclusion: LC may safely be performed as day surgery in children without comorbidities. Shorter duration of anesthesia and early oral feeding seem to play a key role in SDD in these cases.

show abstract

Day case laparoscopic cholecystectomy in children: A review of 11 cases

Cited by 7 publications

References 8 publications

Enhanced Recovery after Surgery Applied to Pediatric Laparoscopic Cholecystectomy for Simple Cholelithiasis: Feasibility and Teaching Insights

Enhanced Recovery after Surgery Applied to Pediatric Laparoscopic Cholecystectomy for Simple Cholelithiasis: Feasibility and Teaching Insights

Paediatric cholelithiasis: our experience at a tertiary care centre

Factors Affecting Same-Day Discharge Following Laparoscopic Cholecystectomy in Children

Contact Info

Product

Resources

About