The following is a summary of “From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day,” published in the JULY 2023 issue of Surgery by Taveras, et al.

The safety of performing laparoscopic cholecystectomy (LC) during nighttime remains a topic of debate. Previous studies have not adequately controlled for disease severity, which could influence outcomes. For a study, researchers sought to analyze the outcomes of LC performed during the day compared to nighttime while controlling for disease severity using the Parkland Grading Scale for Cholecystitis (PGS).

They analyzed the AAST multicenter evaluation of the cholecystitis database. They excluded non-operative cases, open operations, and cases with missing PGS data. The remaining cases were divided based on the start time of the operation. PGS was used as a parameter to control for the severity of the disease. They evaluated operative time, use of bailout techniques, and postoperative complications as primary outcomes.

Out of 759 procedures included in the analysis, 16% were nighttime LC. The two groups had no significant differences in demographics, comorbidities, physiologic variables, or PGS. Operative time (108.6 min vs. 105.6), use of bailout techniques (8.3% vs. 7.4%), and postoperative complications (9.9% vs. 11.3%) were similar between the daytime and nighttime LC groups.

Regardless of the severity of the disease, laparoscopic cholecystectomy is safe to perform at any time of the day or night. The study showed that nighttime LC procedures have a similar complication profile to those performed during the day. Therefore, surgeons can confidently perform LC 24 hours a day without compromising patient safety.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00045-4/fulltext