Ivana Sabolic, Oluwasina Dada, Mahwish Khan, Soyombo Oluwabunmi, Giampiero Soccorso
Birmingham Children's Hospital, Birmingham, United Kingdom
Introduction: The aim of the study is to assess the feasibility and safety of day-case laparoscopic cholecystectomy (DCLC) in paediatric population. We focused on post-operative outcomes as a measure of success and used a protocolised postoperative and post-discharge pain management approach.
Methods: Data was collected from the hospital database from 2016 - 2022. Data collection included demographics, surgeon level, length of stay, complications and postoperative pain management as per hospital protocol which included opioid and/or non-opioid analgesia. A follow-up telephone survey investigated type of analgesia administered at home and length of analgesia administration in days.
Results: Thirty-one patients underwent LC with a day case rate of 77%. Mean age was 11 (range 3-16 years), 63% female. Most cases were idiopathic while 8% secondary to haemolytic disorders. Twenty percent of patients had ASA I, 48% ASA II and 32% had ASA III. Seventy-one percent of DCLC was performed by trainees. Postoperative analgesia for 96% of patients was based on opioids with paracetamol/ibuprofen and prescribed as post-discharge analgesia in 80%. After discharge, patients received oral opioids with paracetamol/ibuprofen from 1 to 7 days; 28% of patients used opioid analgesia at home up to 3 days. No patients required readmission at 30-day. There were no major postoperative complications. After a 3 month follow up, all the patients were discharged.
Conclusion: DCLC can be performed safely with excellent outcomes using a standardised postoperative and post discharge pain management protocol.