Highlights
- •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.
Abstract
Objectives
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).
Methods
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: January 27, 2023
Accepted:
January 26,
2023
Received in revised form:
December 6,
2022
Received:
October 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
