Abstract：
BACKGROUND:Laparoscopic cholecystectomy is the standard surgical management of biliary disease in children, but there has been a paucity of studies addressing outcomes after pediatric cholecystectomies, particularly on a national level. We conducted the first study to address the effect of surgeon specialty and volume on clinical and economic outcomes after pediatric cholecystectomies on a population level. METHODS:We conducted a retrospective cross-sectional study using the Health Care Utilization Project Nationwide Inpatient Sample. Children (≤ 17 years) who underwent laparoscopic cholecystectomy from 2003 to 2007 were selected. Pediatric surgeons performed 90% or higher of their total cases in children. High-volume surgeons were in the top tertile (n ≥ 37 per year) of total cholecystectomies performed. χ(2), Analyses of variance, and multivariate linear and logistic regression analyses were used to assess in-hospital complications, median length of hospital stay (LOS), and total hospital costs (2007 dollars). RESULTS:A total of 3596 pediatric cholecystectomies were included. Low-volume surgeons had more complications, longer LOS, and higher costs than high-volume surgeons. After adjustment in multivariate regression, surgeon volume, but not specialty, was an independent predictor of LOS and cost. CONCLUSIONS:High-volume surgeons have better outcomes after pediatric cholecystectomy than low-volume surgeons. To optimize outcomes in children after cholecystectomy, surgeon volume and laparoscopic experience should be considered above surgeon specialty.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Chen K,Cheung K,Sosa JAdoi
10.1016/j.jpedsurg.2011.10.054subject
Has Abstractpub_date
2012-04-01 00:00:00pages
673-80issue
4eissn
0022-3468issn
1531-5037pii
S0022-3468(11)00929-8journal_volume
47pub_type
杂志文章abstract：PURPOSE:Despite advances in neonatal care of congenital diaphragmatic hernia (CDH), a significant variation exists in the mortality rates reported by individual centers. Center experience (reflected by case volume) may contribute to this variation in outcome. The aim of the study was to determine whether CDH mortality ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpedsurg.2009.01.023
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Several factors are implicated in transabdominal testicular descent, including insulinlike factor 3 (INSL3) hormone and Müllerian-inhibiting substance (MIS). A transgene insertional mutation found on chromosome 5 in the mouse, known as crsp, causes deletion of a transmembrane G protein-coupled receptor gene,...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.08.047
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Fulminant necrotizing enterocolitis (NEC) may result in extensive bowel necrosis. Resection of involved segments may result in short bowel syndrome. Multiple stomas result in complications and further loss of intestinal length with closure. METHODS:Two patients with extensive multisegmental NEC were...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(00)90004-6
更新日期：2000-02-01 00:00:00
abstract：:A case of complete epispadiac urethral duplication is reported. The epispadiac opening was at the base of the penis. This case is unusual because the anatomy was otherwise normal and the incontinence was intermittent. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80442-6
更新日期：1987-02-01 00:00:00
abstract：:The cases of two infants with prenatally diagnosed cystic meconium peritonitis, who underwent minimal surgical procedure (drainage) first and elective surgery later, are reported. Just after birth tube drains were inserted under local anesthesia with ultrasonographic guidance. They underwent laparotomy, at 16 days in ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：PURPOSE:The purpose of the study was to determine if first rib fractures are associated with an increased incidence of thoracic vascular injury in pediatric patients. METHODS:The medical records of all children diagnosed with a first rib fracture or a central vascular injury after blunt trauma treated at a state-desig...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.09.080
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:Anterior sacral meningocele (ASM) and presacral teratoma (PT) are related malformations. Both can have familial occurrence. Surgical treatment of occult cases is essential. Hence, it is important to screen the asymptomatic relatives. Plain radiograph of the sacrum to look for any bony abnormalities i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.28860
更新日期：2001-12-01 00:00:00
abstract：:We present a case of prenatally diagnosed gastroschisis combined with a sternal cleft, as well as the successful surgical management of this unusual condition. Successful management of gastroschisis combined with sternal cleft has not been reported before in the literature. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.03.034
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:Recent reports have demonstrated increasing lethality among young women after inflicted injuries (SII). The aim of this study was to examine sex differences in the methods and outcomes of childhood and adolescent SII. METHODS:The National Trauma Databank (v 7.0) was used to identify all patients 18 years or...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.006
更新日期：2010-04-01 00:00:00
abstract：BACKGROUND:To investigate the safety, feasibility, and complications of pancreatectomies for pediatric pancreatic tumors. METHODS:The medical records of pancreatectomy patients from January 2007 to January 2018 were retrospectively analyzed for perioperative factors and complications. Patients were divided into pancre...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.08.051
更新日期：2020-09-01 00:00:00
abstract：:In this study we investigated whether a low-dose infusion of ATP-MgCl2 could ameliorate the pulmonary hypertension resulting from hypoxic pulmonary vasoconstriction. Three-week-old piglets were anesthetized, intubated, ventilated with room air, and cannulated for the measurement of pulmonary and systemic arterial pres...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80332-4
更新日期：1988-12-01 00:00:00
abstract：:The management of children with a mass in the head of the pancreas is not well defined. The medical records of 3 children with obstructive jaundice because of a mass in the head of the pancreas over a 4-year period were reviewed retrospectively. Abdominal ultrasonography and computed tomography showed intrahepatic and...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.02.029
更新日期：2006-06-01 00:00:00
abstract：PURPOSE:To determine whether hemodynamically significant bleeding occurs after pediatric femur fractures. METHOD:A retrospective chart review was performed; demographic and injury data were collected for all patients with the diagnosis of femur fracture over a 30-month period at a level/ pediatric trauma center. Inclu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90827-1
更新日期：1996-10-01 00:00:00
abstract：:Portal vein thrombosis (PVT) is a rare complication that occurs after liver transplantation: however, it cannot be ignored as a cause of graft loss and death. We herein report a pediatric case of PVT that caused a fatty change in the graft after living donor liver transplantation. The portal vein was successfully reco...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.05.029
更新日期：2005-08-01 00:00:00
abstract：OBJECTIVE:This study aims to evaluate the effect of bladder diverticula (BD) on bladder function using a rabbit model, based on urodynamic findings. METHODS:A total of 32 New Zealand white rabbits were randomly assigned to four groups: (1) sham surgery; (2) a single, 1-cm-diameter BD; (3) a single, large, 3-cm-diamete...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.02.087
更新日期：2016-09-01 00:00:00
abstract：:This is a report of a case in which a significant quantity of sulfuric acid was ingested, causing life threatening respiratory distress, secondary to glottic injury and edema, and cardiovascular collapse. Vigorous resuscitive efforts allowed survival through the first 48 hours and two major operations. Persistent and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80238-0
更新日期：1988-09-01 00:00:00
abstract：BACKGROUND:Regarding the complications associated with short bowel syndrome (SBS), progressive liver failure is one of the most severe complications known to occur: Although several studies have suggested that many factors interactively influence this clinical condition we investigated the relationship between hepatic ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.06.037
更新日期：2005-10-01 00:00:00
abstract：AIM:The authors studied changes in splenic volume after partial splenic embolization (PSE) in children who had thrombocytopenia caused by splenomegaly. MATERIALS AND METHODS:Five children with hypersplenism (ages of 1, 6, 7, 10, and 14 years) underwent PSE. The follow-up period ranged from 1 month to 8 years 9 months....
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90006-8
更新日期：1996-02-01 00:00:00
abstract：:Within 48 hours after birth, newborn rats were anesthetized, and the distal tip of the gubernaculum was exposed extraabdominally, then fixed to the fascia of the groin on the left or the right side under a dissecting microscope (6x). In the sham-operated rats, the distal tip of the gubernaculum was merely exposed. Non...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90483-2
更新日期：1996-04-01 00:00:00
abstract：:Although the protracted use of total parenteral nutrition (TPN) in infants is known to predispose to cholestasis, which in certain instances may not be reversible, failure to understand the pathogenesis of this condition has hindered the development of an effective medical treatment. That surgical treatment may revers...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(85)80042-7
更新日期：1985-12-01 00:00:00
abstract：:Inhibition of fetal breathing movements or increased loss of fetal lung fluid into the amniotic space have been suggested as two possible mechanisms causing pulmonary hypoplasia in the setting of oligohydramnios (OH). We examined the effect of OH produced by amniotic fluid shunting (AS) into the maternal abdominal cav...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80349-8
更新日期：1984-12-01 00:00:00
abstract：:The development of hydrops fetalis and maternal mirror syndrome in the setting of fetal sacrococcygeal teratoma (SCT) carries a grave prognosis. Fetal surgery is not typically offered for hydropic fetuses beyond 26 weeks of gestational age. Few options exist for these families, and they are typically counseled to cont...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.04.010
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Vascular anomalies are a diverse set of lesions with distinct clinical behaviors, whose biomolecular characteristics are largely undefined. Common hemangiomas proliferate during the first year of life, then involute at a variable pace over several years. Other vascular tumors may involute much more q...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.11.043
更新日期：2004-03-01 00:00:00
abstract：:The joining of widely separated proximal and distal esophageal segments in esophageal atresia remains a challenging problem. Livaditis introduced the operation of circular myotomy as an effective means of bridging such a wide gap. Three babies with esophageal atresia were successfully treated in this manner at the Hos...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80453-9
更新日期：1978-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Newborns with congenital diaphragmatic hernia (CDH) still have a high mortality rate, which has been attributed to pulmonary hypoplasia and pulmonary hypertension. Fibroblast growth factors (FGFs) are essential components of the gene network that regulates lung development. Recent studies suggest tha...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(03)00183-0
更新日期：2003-07-01 00:00:00
abstract：PURPOSE:The aim of the study was to report the experience with renal cell carcinoma (RCC) in children. MATERIALS AND METHODS:We conducted a retrospective study on renal adenocarcinoma cases treated in our center between 1993 and 2008. The age limit was established at 15 years. We collected data on personal history, di...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.02.073
更新日期：2009-09-01 00:00:00
abstract：:There is a significant incidence of inguinal hernia in premature infants and the optimal timing of repair is controversial. A high rate of postoperative respiratory complications has been reported in this group. In this study, the records of 47 premature infants (mean gestational age, 30.3 weeks) who underwent hernior...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(05)80285-4
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:There is limited time within the clinical workflow of most pediatric surgeons to obtain a comprehensive, well informed consent. This study evaluates whether ad-lib access to an online video on the consent dialogue enhances the consent process for inguinal hernia repair (IHR) in children. METHODS:The study w...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpedsurg.2019.09.047
更新日期：2020-01-01 00:00:00
abstract：AIM:Extrahepatic portal vein obstruction (EPVO) is a common cause of portal hypertension in children and can lead to life-threatening bleeding, thrombocytopenia, and coagulation disorders. Mesoportal bypass (MPB) restores normal physiologic portal flow to the liver and corrects portal hypertension. There is, however, l...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.019
更新日期：2010-01-01 00:00:00
abstract：:Ovarian neoplasms are unusual in the paediatric age group; the majority of them are of germ cell origin. Malignant epithelial tumours of the ovary occur infrequently in adolescent girls. Ovarian carcinoma in particular is extremely rare before puberty. The authors describe 3 cases of adenocarcinoma of the ovary in pre...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1053/jpsu.2001.21617
更新日期：2001-03-01 00:00:00
