{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:22:03Z","timestamp":1789730523501,"version":"4.0.1"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>Historically, cholecystectomy was infrequently performed in children. Lifestyle changes, delays in health care access, and increases in childhood obesity occurred during the COVID-19 pandemic. The impact of these shifts on need for cholecystectomy are poorly understood. We evaluate trends in cholecystectomy case volume among children during the COVID-19 pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A multi-institutional retrospective cohort study was conducted for children ages 18\u00a0years and younger who underwent cholecystectomy from January 1, 2016, to July 31, 2022, at 10 children\u2019s hospitals. Differences in cholecystectomy case mix and volume before and during the pandemic were identified using bivariate comparisons and interrupted time series analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Overall, 4282 children were identified: 2122 before the pandemic and 2160 during the pandemic. Most were female (74.2%) with a median age of 15\u00a0years (IQR, 13.0\u201316.0\u00a0years). The proportion of Hispanic (55.0% vs 60.1%; P\u2009=\u2009.01) patients, body mass index (BMI) (26.0 vs 27.1; P\u2009&amp;lt;\u2009.001), and obesity (BMI\u2009&amp;gt;\u200930) (30.8% vs 37.4%; P\u2009&amp;lt;\u2009.001) increased during the pandemic. Predicted monthly case volume increased from 40 to 100 during the pandemic. Patients transferred from an outside hospital increased (21.3% vs 28.5%; P\u2009&amp;lt;\u2009.001). Significant increases in acute cholecystitis (12.2% vs 17.3%; P\u2009&amp;lt;\u2009.001), choledocholithiasis (12.8% vs 16.5%; P\u2009=\u2009.001), gallstone pancreatitis (10.6% vs 12.4%; P\u2009=\u2009.064), and chronic cholecystitis (1.4% vs 3.2%; P\u2009&amp;lt;\u2009.001) also occurred. On interrupted time series analysis, change in month-to-month case count significantly increased during the pandemic (Figure\u00a01; P\u2009&amp;lt;\u2009.001), which persisted after exclusion of transferred patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Pediatric cholecystectomy case volume and complexity increased during the COVID-19 pandemic. These findings may be secondary to changes in childhood health, transfer patterns, and shifts in access, highlighting an increased health care burden on children\u2019s hospitals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2024-068065","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:02:33Z","timestamp":1740096153000},"source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Cholecystectomy Case Volume and Complexity Following the COVID-19 Pandemic"],"prefix":"10.1542","volume":"155","author":[{"given":"Olivia A.","family":"Keane","sequence":"first","affiliation":[{"name":"1Department of Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadassa","family":"Ourshalimian","sequence":"additional","affiliation":[{"name":"1Department of Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romeo","family":"Ignacio","sequence":"additional","affiliation":[{"name":"2Division of Pediatric Surgery, Department of Surgery, University of California San Diego, Rady Children\u2019s Hospital San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Acker","sequence":"additional","affiliation":[{"name":"3Department of Surgery, Children\u2019s Hospital Colorado, University of Colorado, Aurora, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Jensen","sequence":"additional","affiliation":[{"name":"4Department of Surgery, University of California San Francisco School of Medicine, and UCSF Benioff Children\u2019s Hospitals, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrine","family":"Lofberg","sequence":"additional","affiliation":[{"name":"5Department of Surgery, Doernbecher Children\u2019s Hospital, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mueller","sequence":"additional","affiliation":[{"name":"6cbaStanford Medicine Children\u2019s Health, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Padilla","sequence":"additional","affiliation":[{"name":"7Division of Pediatric Surgery, Phoenix Children\u2019s Hospital, Pheonix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Pandya","sequence":"additional","affiliation":[{"name":"8Division of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Rothstein","sequence":"additional","affiliation":[{"name":"9Department of Pediatric General and Thoracic Surgery, Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie W.","family":"Russell","sequence":"additional","affiliation":[{"name":"10Division of Pediatric Surgery, Phoenix Children\u2019s Hospital, Pheonix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Smith","sequence":"additional","affiliation":[{"name":"9Department of Pediatric General and Thoracic Surgery, Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MaKayla","family":"O\u2019Guinn","sequence":"additional","affiliation":[{"name":"1Department of Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Ing","sequence":"additional","affiliation":[{"name":"11Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"},{"name":"12Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Floan Sachs","sequence":"additional","affiliation":[{"name":"2Division of Pediatric Surgery, Department of Surgery, University of California San Diego, Rady Children\u2019s Hospital San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Highet","sequence":"additional","affiliation":[{"name":"4Department of Surgery, University of California San Francisco School of Medicine, and UCSF Benioff Children\u2019s Hospitals, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E.","family":"Iantorno","sequence":"additional","affiliation":[{"name":"10Division of Pediatric Surgery, Phoenix Children\u2019s Hospital, Pheonix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Templeton","sequence":"additional","affiliation":[{"name":"8Division of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brielle","family":"Ochoa","sequence":"additional","affiliation":[{"name":"7Division of Pediatric Surgery, Phoenix Children\u2019s Hospital, Pheonix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utsav M.","family":"Patwardhan","sequence":"additional","affiliation":[{"name":"2Division of Pediatric Surgery, Department of Surgery, University of California San Diego, Rady Children\u2019s Hospital San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Peace","sequence":"additional","affiliation":[{"name":"3Department of Surgery, Children\u2019s Hospital Colorado, University of Colorado, Aurora, 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