title: Same day discharge after laparoscopic cholecystectomy in children.
abstract: BACKGROUND
  Although the safety of same day discharge (SDD) after laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis (SC) and biliary dyskinesia (BD) in adults has been well documented in the literature, the same data in the pediatric population are lacking. We have recently instituted a protocol for SDD after LC for SC and BD, and this study is an analysis of our initial experience.
  
  
  METHODS
  A retrospective chart review of all patients who underwent LC for BD and SC in our institution from January 2011-July 2014 was performed.
  
  
  RESULTS
  A total of 227 LC were performed for SC and BD during the study period. Approximately 25% (n = 57) of patients were in the SDD group. The remaining 75% (n = 170) of patients were admitted at least overnight stay (ONS) for the following reasons: medical 16.5% (n = 28), surgery ending too late 4.1% (n = 7), or clinical care habits 79.4% (n = 135). Comparing the SDD group with ONS group, no differences were found in the complication rate, readmissions, or follow up before scheduled appointment. Length of stay was significantly less for the SDD group than for the ONS. A trend for more SDDs was observed as time elapsed from initiation of the protocol. Also, earlier completion of surgery trended toward SDD.
  
  
  CONCLUSIONS
  SDD appears safe for pediatric patients undergoing LC for BD or SC. The main obstacles to discharge were time of surgery completion and clinical care habits, both of which improved as comfort level with SDD grew among the staff.
authors.affiliation: Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Brian G A
authors.initials: BG
authors.lastname: Dalton
authors.affiliation: Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Gonzalez
authors.affiliation: Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Erol Marty
authors.initials: EM
authors.lastname: Knott
authors.affiliation: Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.affiliation: Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri. Electronic address: paguayo@cmh.edu.
authors.forename: Pablo
authors.initials: P
authors.lastname: Aguayo
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D001657:Biliary Dyskinesia / Q000601:surgery*; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies
keywords: Biliary dyskinesia; Children; Cholecystectomy; Same day discharge; Symptomatic cholelithiasis