Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 1540, Floor 15, Block K, Queen Mary Hospital, Pokfulam, Hong Kong, China.
World J Surg. 2023 Dec;47(12):3012-3019. doi: 10.1007/s00268-023-07206-y. Epub 2023 Oct 10.
To evaluate factors affecting length of stay (LOS) after choledochal cyst resection in paediatric patients.
This was a retrospective study on patients operated between 2004 and 2021. Associations between clinical factors and LOS were evaluated by bivariate analysis, multiple regression, and equivalence test.
Sixty-two patients were included. Twenty-four underwent hepaticoduodenostomy as biliary reconstruction. Five suffered from major complications. The median (25th-75th percentile) operation time was 279 (182-378) min. Median LOS, time to enteral feeding, and time to abdominal drain removal were 8(6-10), 2(1-3), and 5(4-7) days, respectively. Seven factors were found significantly associated with a shorter LOS in bivariate analysis and were included in multiple regression. It revealed that early abdominal drain removal (p < 0.001), early enteral feeding (p = 0.042), and the absence of major complications (p < 0.001) were significantly associated with shorter LOS. Equivalence test suggested that age and preoperative cholangitis had no practical effect on LOS.
Early enteral feeding, early drain removal, and avoidance of major complications are associated with a shorter LOS.
评估影响小儿胆总管囊肿切除术后住院时间（LOS）的因素。
这是一项对 2004 年至 2021 年间手术的患者进行的回顾性研究。通过双变量分析、多元回归和等效性检验评估临床因素与 LOS 之间的关系。
共纳入 62 例患者。24 例行肝肠吻合术作为胆道重建。5 例发生严重并发症。手术时间中位数（25 百分位数-75 百分位数）为 279（182-378）min。中位 LOS、肠内喂养开始时间和腹部引流管拔除时间分别为 8（6-10）天、2（1-3）天和 5（4-7）天。双变量分析发现 7 个因素与 LOS 缩短显著相关，并纳入多元回归分析。结果表明，早期腹部引流管拔除（p<0.001）、早期肠内喂养（p=0.042）和无严重并发症（p<0.001）与 LOS 缩短显著相关。等效性检验提示年龄和术前胆管炎对 LOS 无实际影响。
早期肠内喂养、早期引流管拔除和避免严重并发症与 LOS 缩短有关。
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