The Disproportionate Increase in Pediatric Laparoscopic Cholecystectomies During the COVID-19 Pandemic

Abstract

Introduction

The COVID-19 pandemic limited many patients to an unhealthy, sedentary lifestyle, with literature specifically demonstrating an increasing trend of obesity in pediatric patients. The goal of this study is to assess the relationship between the COVID-19 pandemic and total number of laparoscopic cholecystectomies performed pre-COVID compared to during COVID.

Methods

Data between 2017 and 2021 were collected from the National Surgical Quality Improvement Program on patients ≤18 ys who underwent elective or urgent cholecystectomies. Data was categorized as pre-COVID (2017-2018) or during COVID (2020-2021). Analysis subcategories included case acuity (elective versus urgent versus emergent), wound classification, race, weight, and complications.

Results

There were 13,579 pediatric laparoscopic cholecystectomies from 2017 to 2021. The COVID group had 7605 (56.0%) cases, and pre-COVID group 5974 (44.0%). The COVID group had significantly greater average weight and body mass index (BMI) than pre-COVID group (P < 0.001). Increased BMI was associated with increased case acuity and complication rates. Minorities including African Americans and Native American/Pacific Islanders had an increase in number of cholecystectomies performed during COVID. Undergoing a cholecystectomy during COVID was more likely to be classified as urgent or emergent than pre-COVID (P < 0.0001). The COVID group overall had less favorable surgical wound classification as more were classified as class III or class IV cases.

Conclusions

There were increases in weight/BMI, case severity, and total laparoscopic cholecystectomies performed during COVID-19. A statistically significant difference in average weight may suggest a relationship between isolation during the COVID-19 pandemic and rates of cholecystectomy. Future research is encouraged to identify contributing factors in these trends.