From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day

Laparoscopic cholecystectomy (LC) at night remains controversial. Prior studies have not controlled for disease severity. We analyzed outcomes of LC performed day vs. night while controlling for the Parkland Grading Scale for Cholecystitis (PGS). Analysis of the AAST multicenter evaluation of cholec...

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Bibliographic Details
Published in:The American journal of surgery 2023-07, Vol.226 (1), p.83-86
Main Authors: Taveras, L.R., Scrushy, M.G., Cripps, M.W., Kuhlenschmidt, K., Crandall, M., Puri, R., Schroeppel, T.J., Schuster, K.M., Dumas, R.P.
Format: Article
Language:English
Subjects:
Acute care surgery
Cholecystectomy
Cholecystitis
Comorbidity
Complications
Demographic variables
Disease control
Gallbladder
Gallbladder diseases
Hospital costs
Laparoscopic cholecystectomy
Laparoscopy
Length of stay
Mortality
Night
Parkland grading scale
Patient satisfaction
Regression analysis
Sensitivity analysis
Surgery
Variables
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Summary:Laparoscopic cholecystectomy (LC) at night remains controversial. Prior studies have not controlled for disease severity. We analyzed outcomes of LC performed day vs. night while controlling for the Parkland Grading Scale for Cholecystitis (PGS). Analysis of the AAST multicenter evaluation of cholecystitis database was performed. Exclusion criteria included non-operative cases, open operations, and missing PGS. Cases were divided based on operation start time. PGS was used to control for disease severity. Outcomes included operative time, use of bailout techniques and complications. Of 759 procedures identified, 16% were nighttime LC. No differences in demographics, comorbidities, physiologic variables and PGS were noted. Operative time (108.6 min vs 105.6), bailout techniques (8.3% vs 7.4%) and complications (9.9% vs 11.3%) were similar between groups. Regardless of severity, laparoscopic cholecystectomy is safe 24-h a day. Operations performed at night have a similar complication profile to those performed during the day. •Studies assessing the safety of performing laparoscopic cholecystectomy at night have differing results.•No studies evaluating the safety of laparoscopic cholecystectomy at night have controlled for severity of disease.•When controlled for severity, laparoscopic cholecystectomy is safe 24 h a day.•Laparoscopic cholecystectomy done at night decreases time to operation and overall length of stay.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2023.01.029