Same anesthesia ERCP and laparoscopic cholecystectomy in the Pediatric ERCP Database Initiative (PEDI) Experience.

BACKGROUND Successful combined Laparoscopic cholecystectomy and ERCP in the Same Session (LESS) has been reported in several studies in adult patients with choledocholithiasis. METHODS This was a retrospective analysis of data collected prospectively in the Pediatric ERCP Database Initiative using REDCAP. Adverse events were recorded separately and were reviewed for this study. The primary outcome was the hospitalization days. Secondary outcomes included total duration of anesthesia, morbidity, time from diagnosis to procedure. RESULTS 25 patients underwent LESS, and 42 underwent the traditional ERCP followed by laparoscopic cholecystectomy. The groups were similar in age, weight, ASA. The median length of stay in the LESS group was 3 days, compared to 4 days (p = .32). Total procedure time was similar between the two groups, but anesthesia time was shorter in the LESS group (p = .0401). Morbidity was similarly low between the two groups. CONCLUSION Relative to two interventions, a single session combining ERCP and laparoscopic cholecystectomy in pediatric patients is effective with a similar adverse event rate and length of stay. The use of a single sedation and reduced total anesthesia time are potential benefits of this approach. This modality may be considered for pediatric patients with choledocholithiasis with or without hemolytic disease.