Journal article
More Is Less: The Advantages of Performing Concurrent Laparoscopic Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography for Pediatric Choledocholithiasis
Journal of laparoendoscopic & advanced surgical techniques. Part A, v 29(11), pp 1481-1485
Nov 2019
PMID: 31566486
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) are standard of care for pediatric choledocholithiasis. Patients typically undergo separate procedures during hospitalization. Collaboration between surgical and gastroenterology services led to performance of both procedures concurrently during one anesthetic. We hypothesized that concurrent procedures would reduce costs without increasing complications as compared with separate procedures.
We evaluated patients admitted to our institution from 2013 to 2018 with choledocholithiasis who underwent both ERCP and LC during the same admission. Fourteen patients underwent both procedures during concurrent anesthetic. Forty-two patients who underwent LC and ERCP under separate anesthetics were randomly selected to perform a 3:1 matched case-control study. Demographic and clinical data were collected, including imaging and laboratory findings, outcomes, and costs. Comparative analysis was completed with Fisher's exact and Mann-Whitney
tests.
On presentation, there was no difference in common bile duct size, total bilirubin, or white blood cell count between the concurrent and separate procedure cohorts. Significantly, there was no difference in total length of anesthesia (117.9 ± 40 minutes versus 119.6 ± 52 minutes,
= .747). There were also no differences in complications, emergency department visits, or readmissions. Patients who underwent concurrent procedures had significantly lower total cost of stay ($45,597 ± 11,513 versus $61,008 ± 17,960,
= .006).
In pediatric patients with choledocholithiasis, performing LC and ERCP may be performed concurrently during one anesthetic, which decreases costs without increasing in anesthesia time or complications.
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Details
- Title
- More Is Less: The Advantages of Performing Concurrent Laparoscopic Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography for Pediatric Choledocholithiasis
- Creators
- Kristin M Gee - The University of Texas Southwestern Medical CenterRuth Ellen Jones - The University of Texas Southwestern Medical CenterCameron Casson - The University of Texas Southwestern Medical CenterBradley Barth - The University of Texas Southwestern Medical CenterDavid Troendle - The University of Texas Southwestern Medical CenterAlana L Beres - The University of Texas Southwestern Medical Center
- Publication Details
- Journal of laparoendoscopic & advanced surgical techniques. Part A, v 29(11), pp 1481-1485
- Publisher
- Mary Ann Liebert
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000488234400001
- Scopus ID
- 2-s2.0-85074735579
- Other Identifier
- 991021969475804721
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- Web of Science research areas
- Surgery