- •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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- An acute care surgery model improves timeliness of care and reduces hospital stay for patients with acute cholecystitis.Am Surg. 2011; 77: 1318-1321
- Impact of acute care surgery on biliary disease.J Am Coll Surg. 2010; 210 (99-599) ([published Online First: Epub Date]|)): 595-599https://doi.org/10.1016/j.jamcollsurg.2009.12.036(
- Is nighttime the right time? Risk of complications after laparoscopic cholecystectomy at night.J Am Coll Surg. 2014; 219 ([published Online First: Epub Date]|)): 718-724https://doi.org/10.1016/j.jamcollsurg.2014.05.009(
- Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis.Int J Surg. 2015; 18 ([published Online First: Epub Date]|)): 196-204https://doi.org/10.1016/j.ijsu.2015.04.083(
- Laparoscopic cholecystectomy is safe both day and night.J Surg Res. 2019; 233 ([published Online First: Epub Date]|)): 163-166https://doi.org/10.1016/j.jss.2018.07.071(
- Discussion of: "Day versus night laparoscopic cholecystectomy for acute cholecystitis: a comparison of outcomes and cost.Am J Surg. 2017; 214 ([published Online First: Epub Date]|)): 1028-1029https://doi.org/10.1016/j.amjsurg.2017.09.028(
- Outcomes following out-of-hours acute cholecystectomy: a systematic review and meta-analysis.J Trauma Acute Care Surg. 2022; 92 ([published Online First: Epub Date]|)): 447-455https://doi.org/10.1097/ta.0000000000003402(
- The Parkland grading scale for cholecystitis.Am J Surg. 2018; 215 ([published Online First: Epub Date]|)): 625-630https://doi.org/10.1016/j.amjsurg.2017.05.017(
- Prospective validation of the Parkland grading scale for cholecystitis.Am J Surg. 2019; 217 ([published Online First: Epub Date]|)): 90-97https://doi.org/10.1016/j.amjsurg.2018.08.005(
- Multicenter validation of the American Association for the Surgery of Trauma grading scale for acute cholecystitis.J Trauma Acute Care Surg. 2021; 90 ([published Online First: Epub Date]|)): 87-96https://doi.org/10.1097/ta.0000000000002901(
- Time and cost analysis of gallbladder surgery under the acute care surgery model.J Trauma Acute Care Surg. 2014; 76 ([published Online First: Epub Date]|)): 710-714https://doi.org/10.1097/ta.0000000000000117(
- Day versus night laparoscopic cholecystectomy for acute cholecystitis: a comparison of outcomes and cost.Am J Surg. 2017; 214 ([published Online First: Epub Date]|)): 1024-1027https://doi.org/10.1016/j.amjsurg.2017.08.027(
- Timely care is patient-centered care for patients with acute cholecystitis at a safety-net hospital.World J Surg. 2021; 45 ([published Online First: Epub Date]|)): 72-78https://doi.org/10.1007/s00268-020-05764-z(
- Is nighttime really not the right time for a laparoscopic cholecystectomy?.Chin J Gastroenterol Hepatol. 2018; 2018 ([published Online First: Epub Date]|))6076948https://doi.org/10.1155/2018/6076948(
- Can it wait until morning? A comparison of nighttime versus daytime cholecystectomy for acute cholecystitis.Am J Surg. 2014; 208 (discussion 17-8 doi:) ([published Online First: Epub Date]|)): 911-918https://doi.org/10.1016/j.amjsurg.2014.09.004(
Published online: January 27, 2023
Accepted: January 26, 2023
Received in revised form: December 6, 2022
Received: October 24, 2022
Publication stageIn Press Journal Pre-Proof
© 2023 Elsevier Inc. All rights reserved.