Spare the Needle, Discharge the Child: Trending Post-Op Labs After Laparoscopic Common Bile Duct Exploration in Pediatric Patients Is Not Helpful

Laparoscopic common bile duct exploration (LCBDE) utility in management of choledocholithiasis may decrease length of stay and patient cost, but postoperative management remains widely debated. We examined periprocedural LFTs for patients undergoing LCBDE and endoscopic retrograde cholangiopancreato...

Full description

Saved in:

Bibliographic Details
Published in:	The American surgeon Vol. 90; no. 6; p. 1731
Main Authors:	Patterson, James W, Niebler, Jacob A P, Cambronero, Gabriel E, Sanin, Gloria D, Bosley, Maggie E, Reid, Garrett, Ganapathy, Aravindh, Rauh, Jess, Ladd, Mitchell, Pranikoff, Tom, Sieren, Leah M, Petty, John K, Neff, Lucas P
Format:	Journal Article
Language:	English
Published:	United States 01-06-2024
Subjects:	Adolescent Child Child, Preschool Cholangiopancreatography, Endoscopic Retrograde Choledocholithiasis - surgery Common Bile Duct - surgery Female Humans Laparoscopy Liver Function Tests Male Postoperative Care - methods Retrospective Studies endoscopic retrograde cholangiopancreatography laparoscopic common bile duct exploration choledocholithiasis
Online Access:	Get more information
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Laparoscopic common bile duct exploration (LCBDE) utility in management of choledocholithiasis may decrease length of stay and patient cost, but postoperative management remains widely debated. We examined periprocedural LFTs for patients undergoing LCBDE and endoscopic retrograde cholangiopancreatography (ERCP) speculating for trend existence after successful LCBDE. We hypothesized that postoperative LCBDE LFTs would not downtrend even after successful ductal clearance. We identified 99 patients under 18 who underwent ERCP or LCBDE with at least one pre- and post-procedural LFT. Periprocedural LFTs between groups were compared using Wilcoxon signed-rank tests. The 22 ERCP patients demonstrated a significant downtrend across Tbili ( < .001), AST ( = .001), ALT ( = .002), and ALP ( < .001). The 27 LCBDE patients demonstrated a significant downtrend in Tbili ( = .002) only, while AST ( > .05), ALT ( > .05), and ALP ( > .05) were nonsignificant. Lack of consistent downtrend in the LCBDE group raises doubt regarding the utility of postoperative LFTs for post-procedural management.
ISSN:	1555-9823
DOI:	10.1177/00031348241227198