November 4, 2019

Cholecystectomy tied to better outcomes when performed soon after admission

By: Judy Mathias

Editor's Note

Delaying a cholecystectomy for acute cholecystitis more than 3 days after admission increased the rate of complications, hospital readmissions, and lengthened hospital stays, in this study presented October 30 at the American College of Surgeons Clinical Congress 2019 in San Francisco.

Using 2012 to 2016 ACS National Surgical Quality Improvement Program data, researchers divided some 50,000 cases into three groups: those who had their gallbladders removed within 24 hours of admission (12,968), patients who went to the OR between 24 and 72 hours after admission (26,578), and those whose surgery was delayed 72 hours or more after admission (9,594).

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Patients who had surgery within 24 hours, went home the next day. When the procedure was delayed 72 hours or more, length of stay increased to 5 days, and the patient was 28% more likely to have an open procedure.

Delaying the procedure for 72 hours or more also increased the odds of sepsis by some 50%, venous thrombus embolism by more than 80%, surgical site infection by 20%, and 30-day readmission by 25%.

The data suggest that patients should have surgery as soon as the diagnosis is made, and they shouldn’t wait until Monday if they are admitted on a weekend, the researchers say.


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