Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 Jul 29:2018:6076948.
doi: 10.1155/2018/6076948. eCollection 2018.

Is Nighttime Really Not the Right Time for a Laparoscopic Cholecystectomy?

Anna C M Geraedts  1 , Meindert N Sosef  1 , Jan Willem M Greve  1 , Mechteld C de Jong  1
Affiliations
Comparative Study

Is Nighttime Really Not the Right Time for a Laparoscopic Cholecystectomy?

Anna C M Geraedts et al. Can J Gastroenterol Hepatol. .

Abstract

Purpose: The impact of an out-of-hours laparoscopic cholecystectomy on outcome is controversial. We sought to determine the association between an out-of-hours procedure and postoperative complications within 90 days.

Methods: Between 2014 and 2016, 1553 laparoscopic cholecystectomies were performed. Therapeutic, operative, and outcome data were prospectively collected and analyzed. We defined out of hours as during weekends, national holidays, and daily between 5PM and 8AM.

Results: Most patients operated on were female (n=988; 63.6%) and the majority of procedures were electives (n=1341; 86.3%). Although all procedures were performed with a laparoscopic intent, 42 (2.7%) were converted to open procedure. In total, 145 (9.3%) procedures were out of hours, all nonelective, and in most cases for acute cholecystitis (n=111; 7.1%). Overall, there were 212 complications in 191 patients (12.3%), most (n=153; 9.9%) classified as minor. The conversion rate in the out-of-hours group was significantly higher (9.7% vs 2.0%; p<0.001). While univariate analyses revealed out-of-hours procedure (OR=1.83; p=0.008) to be associated with an increased risk of complications, when controlling for confounding factors by multivariate analysis, this association was not found. However, operation by surgical staff (OR=1.71) and conversion to laparotomy (OR=3.74) were found to be independently associated with an increased risk of complications (both p<0.05), while an emergency procedure tended to be associated with postoperative morbidity (OR=1.82; p=0.069).

Conclusion: An out-of-hours laparoscopic cholecystectomy was not found to be an independent risk factor for developing postoperative morbidity and time of day should therefore only be a relative contraindication.

PubMed Disclaimer

References

    1. Litwin D. E. M., Cahan M. A. Laparoscopic Cholecystectomy. Surgical Clinics of North America. 2008;88(6):1295–1313. doi: 10.1016/j.suc.2008.07.005. - DOI - PubMed
    1. Litynski G. S. Highlights in the History of Laparoscopy. Frankfurt, Germany: Barbara Bernert Verlag; 1996.
    1. Vecchio R., Macfayden B. V., Palazzo F. History of laparoscopic surgery. Panminerva Medica. 2000;42(1):87–90. - PubMed
    1. Strasberg S. M., Brunt L. M. Rationale and Use of the Critical View of Safety in Laparoscopic Cholecystectomy. Journal of the American College of Surgeons. 2010;211(1):132–138. doi: 10.1016/j.jamcollsurg.2010.02.053. - DOI - PubMed
    1. Ricci W. M., Gallagher B., Brandt A., Schwappach J., Tucker M., Leighton R. Is after-hours orthopaedic surgery associated with adverse outcomes?: a prospective comparative study. The Journal of Bone & Joint Surgery. 2009;91(9):2067–2072. doi: 10.2106/jbjs.h.00661. - DOI - PubMed

Publication types

LinkOut - more resources