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Updated: Jun 17, 2025
The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
National analysis of outcomes in timing of cholecystectomy for acute cholangitis
Ayesha P Ng1, Young-Ji Seo1, Konmal Ali1
1Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Background:
The present study aimed to compare outcomes between cholecystectomy on index versus delayed admission for acute cholangitis.
Methods:
The 2011-2020 Nationwide Readmissions Database was used to identify adult patients admitted for acute cholangitis who underwent cholecystectomy. Study cohorts were defined based on timing of surgery. Multivariable regressions and Royston-Parmar time-adjusted analysis were used to evaluate the association of cholecystectomy timing and outcomes.
Results:
Of 65,753 patients, 82.0 % received surgery on Index and 18.0 % on Delayed admissions. Following adjustment, Delayed operation was associated with significantly increased odds of mortality (AOR 1.67 [95 % CI 1.10-2.54]), complications (1.25 [1.13-1.40]), repair of bile duct injury (1.66 [1.15-2.41]), conversion to open (1.69 [1.48-1.93]), and 30-day readmission (3.52 [3.21-3.86]). The Delayed cohort experienced a +$14,200 increment in hospitalization costs relative to Index.
Conclusions:
Delayed cholecystectomy for acute cholangitis is significantly associated with adverse postoperative outcomes, suggesting that index cholecystectomy may be safe to perform.
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