Can it wait until morning? A comparison of nighttime versus daytime cholecystectomy for acute cholecystitis

被引：46

作者：

Wu, James X. ^{[1
]}

Nguyen, Andrew T. ^{[2
]}

de Virgilio, Christian ^{[1
,2
]}

Plurad, David S. ^{[2
]}

Kaji, Amy H. ^{[2
]}

Nguyen, Virginia ^{[2
]}

Gifford, Edward ^{[2
]}

de Virgilio, Michael ^{[2
]}

Ayabe, Reed ^{[2
]}

Saltzman, Darin ^{[1
]}

Kim, Dennis ^{[2
]}

机构：

[1] Univ Calif Los Angeles, David Geffen Sch Med, Olive View UCLA Med Ctr, Dept Surg, Los Angeles, CA 90095 USA

[2] Harbor UCLA Med Ctr, Dept Surg, Los Angeles, CA 90027 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2014年 / 208卷 / 06期

关键词：

Acute cholecystitis; Laparoscopic cholecystectomy; Nighttime; LAPAROSCOPIC CHOLECYSTECTOMY; NO NEED; COMPLICATIONS; ADMISSION; TIME; SURGEONS; OUTCOMES;

D O I：

10.1016/j.amjsurg.2014.09.004

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: The urgency of laparoscopic cholecystectomy for acute cholecystitis is under debate. We hypothesized that nighttime cholecystectomy is associated with decreased length of stay. METHODS: Retrospective review of 1,140 patients at 2 large urban referral centers with acute cholecystitis who underwent daytime (7 am to 7 pm) versus nighttime (7 pm to 7 am) cholecystectomy was conducted. RESULTS: Nighttime cholecystectomy did not affect the overall length of stay (3.7 vs 3.8 days, P = .08) or complication rate (5% vs 7%, P = .5) versus daytime cholecystectomy. Nighttime cholecystectomy was associated with a higher conversion rate to open cholecystectomy (11% vs 6%, P = .008). On multivariable analysis, independent predictors of conversion to open surgery were nighttime cholecystectomy, age, and gangrenous cholecystitis (P = .01). The only predictor of complications was gangrenous cholecystitis (P = .02). CONCLUSIONS: Nighttime cholecystectomy is associated with an increased conversion to open surgery without decrease in length of stay or complications. These findings suggest that laparoscopic cholecystectomy for acute cholecystitis should be delayed until normal working hours. (C) 2014 Elsevier Inc. All rights reserved.

引用

页码：911 / 917

页数：7

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