Same day discharge protocol implementation trends in laparoscopic cholecystectomy in pediatric patients.
OBJECTIVE
After investigating barriers for same day discharge (SDD) after laparoscopic cholecystectomy (LC), we employed a protocol which we have followed with a prospective, observational study.


METHODS
A single institution, prospective observational study was performed from July 2014 to 2015 (2nd period). These data were compared to our initial experience with an SDD protocol from January 2013 to July 2014 (1st period).


RESULTS
A total of 191 LCs were analyzed, 116 in the 1st period and 75 in the second period. In the 1st period, 47% were discharged the same day compared to 78% in the 2nd period (P<0.001). There was no difference in postoperative complications or readmissions between those discharged and those who spent the night. Additionally, there was no difference between admitted and SDD patients in age, BMI, or gender. Reasons for admission included pain (12%) and emesis (12%), and 1 patient had a syncopal event. However, the majority stayed with no identifiable patient factor.


CONCLUSIONS
SDD after LC is safe and effective and implementing and revising a standardized clinical protocol can substantially improve the success of SDD.


METHODS
Retrospective comparative study, level III.
Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
Joanna L
JL
Gould
Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
Ashwini S
AS
Poola
Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
Shawn D
SD
St Peter
Department of Surgery, Children's Mercy Hospital, Kansas City, MO. Electronic address: paguayo@cmh.edu.
Pablo
P
Aguayo
D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D002985:Clinical Protocols; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D010351:Patient Discharge; D011446:Prospective Studies
Biliary dyskinesia; Cholecystectomy; Protocol; Same day discharge; Symptomatic cholelithiasis