Analysing Factors Prolonging Hospital Stay After Excision of Choledochal Cyst—A Pathway Towards Enhanced Recovery After Surgery

Abstract

<h3>Background</h3><p>To evaluate factors affecting length of stay (LOS) after choledochal cyst resection in paediatric patients.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>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 (<em>p</em> < 0.001), early enteral feeding (<em>p</em> = 0.042), and the absence of major complications (<em>p</em> < 0.001) were significantly associated with shorter LOS. Equivalence test suggested that age and preoperative cholangitis had no practical effect on LOS.</p><h3>Conclusions</h3><p>Early enteral feeding, early drain removal, and avoidance of major complications are associated with a shorter LOS.</p>