Utility of routine intraoperative cholangiogram during cholecystectomy in children: A nationwide analysis of outcomes and readmissions

Hallie J. Quiroz, Samantha F. Valencia, Brent A. Willobee, Anthony R. Ferrantella, Emily L. Ryon, Chad M. Thorson, Juan E. Sola, Eduardo A. Perez

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study aims to determine postoperative outcomes and readmissions in pediatric cholecystectomy with routine intraoperative cholangiogram (IOC) utilization. Methods: The Nationwide Readmissions Database 2010–2014 was queried for all pediatric cholecystectomies. A propensity score-matched analysis (PSMA) with over 30 covariates was performed between cholecystectomy alone (CCY) versus those with routine IOC (CCY + IOC, no biliary obstruction, dilatation, or pancreatitis). χ2 analysis or Mann-Whitney U were used for statistical analysis with p < 0.05 set as significant. Results: 34,390 cholecystectomies were performed: 92% were laparoscopic, most were teenage females (75%, 15 years [13–17]) and did not undergo IOC (75%). Postoperative mortality rate was 0.1%. The PSMA cohort comprised of 1412 CCY and 1453 CCY + IOC. Patients with CCY alone had higher rates of 30-day (7% vs 5%), 1-year readmissions (13% vs 11%) and had higher rates of overall complications (22% vs 12%) compared with CCY + IOC, all p < 0.05. Although uncommon, bile duct injuries were more prevalent in CCY (2% vs 0%, p < 0.001), while there was no difference in readmissions for retained stones. Resource utilization was increased in CCY patients, likely due to increased complication rates. Conclusion: This nationwide PSMA suggests pediatric CCY with routine IOC is associated with decreased readmissions, overall resource utilization, complications, and bile duct injuries. Type of Study: Retrospective Comparative Study. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of Pediatric Surgery
Volume56
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • Cholecystectomy
  • Intraoperative cholangiogram
  • Readmissions

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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