Factors Affecting Same-Day Discharge Following Laparoscopic Cholecystectomy in Children

Abstract

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.