Study finds gallbladder surgery can wait

Laparoscopic cholecystectomy, a minimally invasive procedure to remove the gallbladder, is one of the most common abdominal surgeries in the U.S. Yet medical centers around the country vary in their approaches to the procedure with some moving patients quickly into surgery while others wait.

In a study published online Monday in the American Journal of Surgery, researchers found gallbladder removal surgery can wait until regular working hours rather than rushing the patients into the operating room at night.

“The urgency of removing the gallbladder is a topic of much debate among medical professionals,” said Dennis Kim, MD, a Los Angeles Biomedical Research Institute (LA BioMed) lead researcher and author of the study. “We found patients who underwent the surgery during normal working hours were more likely to have the minimally invasive surgical procedure than those undergoing the procedure at night. Those undergoing nighttime surgeries – to a greater extent – experienced more invasive gallbladder removal.”

The gallbladder is a pear-shaped organ on the upper right side of the abdomen that collects and stores bile, a digestive fluid produced by the liver. Gallbladders may need to be removed from patients who suffer pain from gallstones that block the flow of bile.

In a laparoscopic cholecystectomy, surgeons insert a tiny video camera and special surgical tools through small incisions in the abdomen to remove the gallbladder. Occasionally, surgeons may need to create a large incision to remove the gallbladder, and this is known as an open cholecystectomy.

For the American Journal of Surgery, the researchers conducted a retrospective study of 1,140 patients at two large urban referral centers who underwent gallbladder removal surgeries. They found 11% of the surgical procedures performed at night (7 a.m.-7 p.m.) were converted to the more invasive procedure, open cholecystectomies. Only 6% of those who underwent the surgery during the day required the more invasive form of surgery.

The researchers found no significant differences in the length of stay or complication rates. But they said the complication rates were difficult to measure because of the lack of follow-up records for the patients after they left the hospital.

Research funding was partially supported by H.H. Lee Research Award. Others who participated in the study were: LA BioMed researchers Andrew T. Nguyen, MD; Christian de Virgilio, MD, and David S. Plurad. Other researchers were from Olive View Medical Center and the David Geffen School of Medicine at UCLA: Amy H. Kaji, MD, PhD; Edward Gifford, MD; Darin Saltzman, MD; James X. Wu, MD; Reed Ayabe; Michael de Virgilio, and Virginia Nguyen.

About LA BioMed

Founded in 1952, LA BioMed is one of the country's leading nonprofit independent biomedical research institutes. It has approximately 100 principal researchers conducting studies into inherited diseases, infectious diseases, illnesses caused by environmental factors and more. It also educates young scientists and provides community services, including prenatal counseling and childhood nutrition programs. LA BioMed is academically affiliated with the David Geffen School of Medicine at UCLA and located on the campus of Harbor-UCLA Medical Center. For more information, please visit http://www.LABioMed.org