“Surgery First” vs. “Endoscopy First” for Pediatric Choledocholithiasis Presenting at the End of the Week - A CARES Working Group Study
Author / Expert
Garrett Reid, Jessica L. Rauh, Elizabeth Wood, Goeto Dantes, Matthew T. Santore, Marshall W. Wallace, Irving J. Zamora, Amelia Collings, Kylie Callier, Bethany J. Slater, Derek Krinock, Sabina Siddiqui, Robert Vandewalle, Amanda Witte, Katherine Flynn-O-B
Topic overview
Choledocholithiasis in children is commonly managed with an “endoscopy-first” (EF) strategy (endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC)). Because ERCP availability is often limited at the end of the week (EoW), we hypothesized that a “surgery-first” (SF) approach (LC with intraoperative cholangiogram (IOC) ± transcystic laparoscopic common bile exploration (LCBDE)) would decrease length of stay (LOS) and time to definitive intervention (TTDI).
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