Original Research Article|Articles in Press

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

Published:January 27, 2023DOI:


      • 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.



      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.


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