72239 - Cholecystectomy for acute cholecystitis during weekend compared to delayed weekday surgery– a nationwide population study
Magnus Edblom, Lars Enochsson, Hanna Nyström, Gabriel Sandblom, Urban Arnelo, Oskar Hemmingsson, Ioannis GkekasAbstract
Introduction
The optimal timing of surgery for acute cholecystitis has been subject for debate, but the predominant view supports early cholecystectomy. This study investigates the safety of early cholecystectomy during weekends compared to delaying until weekdays.
Method
A population-based cohort study based on data from GallRiks (Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreateatography). Data from cholecystectomies 2006-2020 were analysed. Patients operated on during weekends were compared with patients in hospital during weekends and undergoing surgery on any subsequent weekday. Statistical analyses were conducted using logistic regression analysis.
Result
15 730 patients were included, and a complication was registered in 2 246 patients (14.3%). The proportion of complications was equal in both groups (14.0% vs. 14.5%, p= 0.365) and after adjustment for for confounding factors, there still was no significant difference in complications ratio. The proportion of open surgery was higher in the weekend surgery group (29.1% vs. 26.3%), with an odds ratio of 1.32 in multivariate logistic regression analysis (p<0.001). Meanwhile, duration of surgery exceeding 2 hours was less common when surgery was performed on the weekend (32.7% vs. 46.8%, p=<0.001). No difference were seen in the ratio of bile duct injuries.
Discussion
In this study, procedures carried out during weekends had outcomes that did not substantially differ from those performed during weekdays. More procedures were completed with open surgery during weekends, but less procedures had operating time exceeding two hours. The results of our study support performing early cholecystectomies during the weekend without increasing the patients’ risk of complications.