title: Safety of outpatient laparoscopic cholecystectomy in children: analysis of 2050 elective ACS NSQIP-pediatric cases.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  This analysis of a large multicenter dataset demonstrates that pediatric patients without significant associated comorbidities can safely undergo laparoscopic cholecystectomy as an outpatient procedure.
authors.affiliation: Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Sacco Casamassima
authors.affiliation: Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Colin
authors.initials: C
authors.lastname: Gause
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Goldstein
authors.affiliation: Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Swarup
authors.affiliation: Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. FAbdullah@luriechildrens.org.|Ann & Robert H Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 63, Chicago, IL, 606011, USA. FAbdullah@luriechildrens.org.
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D010045:Outpatients; D014481:United States
keywords: Gallbladder disease; Laparoscopic cholecystectomy; NSQIP; Outcomes; Pediatric cholecystectomy