Study Shows Nighttime Not Always Right Time for Even Urgent Surgery

The urgency to perform a cholecystectomy for acute cholecystitis has come into question following a recent study published by the American Journal of Surgery. The study found nighttime surgeries (7pm to 7am), were converted from lapto open procedures 11% of the time, while only 6% of daytime surgeries (7am to 7pm) were converted. Thus, this opens the discussion on whether the urgency to perform such surgeries is beneficial for both the patient and the hospital.

Cholecystectomies rank among the most common surgical procedures in the United States, andimprovements in the performance of these cases can have significant impact. As a result of the study's findings Dennis Kim, MD, of the Harbor-UCLA Medical Center, is suggesting delaying the operation until normal working hours, even though a faster time to surgery may be available. Delaying to normal working hours is supported by the differences in the Length of Case Time, as nighttime surgeries have a mean of 110.5 minutes with daytime surgeries being 92.4 minutes.

What is your policy on performing cholecystectomy in acute cases after hours? Have you seen a difference in case length?