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Navigating Limited Resources-Outpatient Pediatric Cholecystectomies at Rural Hospitals.
J Pediatr Surg
January 2025
Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 42, Torrance, CA 90502, USA; Division of Pediatric Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 77-123 CHS, Los Angeles, CA 90095, USA. Electronic address:
Background: Rural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.
Methods: The Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018.
Biliary Dyskinesia and Hyperkinesis.
Surg Clin North Am
December 2024
Department of Medicine, CSC Health, 767 North Hill Street Suite 200, Los Angeles, CA 90012, USA.
Biliary dyskinesia refers to a group of functional and motility disorders of the biliary system in patients presenting with typical biliary pain, but without any visible structural abnormalities on standard imaging. The Rome IV Criteria establishes diagnostic criteria for functional gallbladder disorder (gallbladder dyskinesia and biliary hyperkinesia), functional biliary sphincter of Oddi disorder (biliary dyskinesia), and pancreatic sphincter of Oddi disorder. Many diagnostic adjuncts such as hepatobiliary scintigraphy and sphincter of Oddi manometry exist, although these results are supportive and not necessarily diagnostic for biliary dyskinesia.
View Article and Find Full Text PDFSphincterotomy for biliary sphincter of Oddi disorder and idiopathic acute recurrent pancreatitis: the RESPOnD longitudinal cohort.
Gut
December 2024
Medicine, DDC, Medical University of South Carolina, Charleston, South Carolina, USA.
Objective: Sphincter of Oddi disorders (SOD) are contentious conditions in patients whose abdominal pain, idiopathic acute pancreatitis (iAP) might arise from pressurisation at the sphincter of Oddi. The present study aimed to measure the benefit of sphincterotomy for suspected SOD.
Design: Prospective cohort conducted at 14 US centres with 12 months follow-up.
Evaluation and Management of Biliary Dyskinesia in Children and Adolescents: A Systematic Review From the APSA Outcomes and Evidence-Based Committee.
J Pediatr Surg
November 2024
Division of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Article Synopsis
- The diagnosis and management of biliary dyskinesia in children and adolescents is inconsistent, prompting a systematic review by the American Pediatric Surgical Association to create evidence-based recommendations.
- The review focused on key areas such as diagnostic criteria, the need for cholecystectomy, and outcomes from surgical vs. non-surgical management, but found that diagnostic criteria are unclear and reliable predictors of treatment success are lacking.
- Pediatric-specific guidelines are needed to clarify this condition, improve diagnostic processes, and determine effective management, along with calls for more prospective studies to identify which patients could benefit from surgery.
The Management of Dysfunctional Gallbladder Disease and the Role of Laparoscopic Cholecystectomy on Symptom Improvement: A Retrospective Cohort Study.
Cureus
July 2024
General Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, GBR.
Background Biliary dyskinesia (BD) is a disorder characterised by abdominal pain of biliary origin (i.e., sudden steady pain at the right upper quadrant of the abdomen or the epigastrium, the absence of gallstones on ultrasound (US)), and a decreased gallbladder ejection fraction (GBEF) on a cholecystokinin-cholescintigraphy hepatobiliary iminodiacetic acid (CCK-HIDA) scan.
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