Taveras LR, Scrushy MG, Cripps MW, Kuhlenschmidt K, Crandall M, Puri R, Schroeppel TJ, Schuster KM, Dumas RP. From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day.
Am J Surg 2023:S0002-9610(23)00045-4. [PMID:
36746709 DOI:
10.1016/j.amjsurg.2023.01.029]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
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.
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