Quick Literature Updates Episode 12

Hello pediatric surgery family. I'm Em Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with StayCurren, we share knowledge to improve child health around the globe. Today, our team is going to deliver the articles that you should know about. We have three papers today. The first two are from the Journal of Pediatric Surgery, and the last one is from Pediatric Surgery International. We don't have much time, so let's start. Our first paper titled, Making Common Duct Exploration Common: Balloon sphincteroplasty is an adjunct to the transystic laparoscopic common bile duct exploration for pediatric patients by Raugh at all. This paper is summarized by Ellen and Cisco. She was a research fellow at Cincinnati Children's Hospital, and as of last month, she is back to being a general surgery resident at Mayo Clinic. In this study, the authors reviewed their experience with laparoscopic common bile duct exploration with balloon sphincteroplasty for patients with pediatric choledocholithiasis. This was a retrospective review at their institution between 2018 and 2021. In the paper, they include illustrations and a description of their technique for laparoscopic common bile duct exploration with balloon sphincteroplasty. And they compared these patients with patients who had standard laparoscopic cholecystectomy with ERCP and a patient who had laparoscopic common bile duct exploration with standard techniques, meaning no balloon sphincteroplasty. They found that doing the balloon sphincteroplasty was associated with an increased operative time, but was also associated with 100% success rate, meaning those patients didn't need an ERCP after the procedure. That some of the patients who had a laparoscopic common bile duct exploration with standard techniques did need an ERCP after the procedure. And laparoscopic cholecystectomy with ERCP was associated with an increased length of hospital stay and with more complications like stent placements and stent migration. So for pediatric patients with choledocholithiasis, laparoscopic common bile duct exploration may be a good option and can be combined with balloon sphincteroplasty, and it can be associated with decreased hospital length of stay and decreased complications. This was awesome. Now, our second paper is: Cervical Collar Clearance in Obtunded Children Presenting Without a Known Traumatic Mechanism: Is Imaging Necessary? by Vu at all. And this paper is summarized by Alex Halpern. He is one of our contributors here at StayCurren MD and a general surgery resident at George Washington University. When a pediatric patient who's found down without a known traumatic mechanism of injury presents to your emergency room, there are no clear guidelines as to whether or not these kids should be placed in a cervical collar. Some clinicians will place them in a cervical collar just to be safe, but is this what's best for the kids? We know that C-collars don't come without risks, and the incidence of C-spine injury in this population is very low. Dr. Grant and her team from Penn State performed a 10-year retrospective chart review trying to answer this question. They looked at all 464 obtunded pediatric patients without a known traumatic mechanism of injury who presented to their pediatric ICU and whether or not they were placed in a cervical collar. They found that 8.4% of these kids were placed in C-collars, and the kids placed in C-collars received significantly more imaging. There was zero C-spine injuries in this entire patient cohort. These new findings raise questions as to whether or not these 100 pediatric patients without a known traumatic mechanism of injury should be placed in a C-collar. And here's the last paper of the day. Is postoperative transanastomotic feeding beneficial in neonates with congenital duodenal obstruction by Treider at all. This one is summarized by Cecilia Hijena. She's a research fellow at Cincinnati Children's Hospital. This is a retrospective study done in Norway, and aimed to evaluate the positive and negative effects of a transllastomactic tube after a congenital deal obstruction repair. Between 2003 and 2020, they analyzed 100 patients. Of them, 37% received a transllastomactic feeding tube. And what they found is that these patients with a feeding tube had two days less of TPN and they started or feeding 1.5 days earlier. Also, they got fewer central venous catheter. So, it seems that transtic feeding tubes are beneficial in patients with congenital duodenal obstruction. Check the link in the description below to read each paper. We hope you like this episode. Please follow us on social media, give us a rating, and subscribe to our YouTube channel. And don't forget to download our StayCurren app on App Store or Play Store for more content. Thank you for listening. Cincinnati Children's Hospital and StayCurren are sharing knowledge to improve child health around the globe.