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The following is a summary of “Cholecystectomy for acute cholecystitis during the weekend compared with delayed weekday surgery: A Nationwide Population Cohort study,” published in the April 2025 issue of Surgery by Edblom et al. 

The timing of surgical intervention for acute cholecystitis has long been a subject of clinical debate, with growing consensus favoring early cholecystectomy to reduce complications and improve patient outcomes. However, hesitancy persists regarding weekend surgical procedures due to potential concerns over staffing, resource availability, and operative risk. This population-based cohort study aimed to assess the safety and efficacy of performing early cholecystectomy on weekends compared to deferring the procedure to a weekday. Using data from the Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks), researchers analyzed records spanning from 2006 to 2020, focusing on patients admitted with acute cholecystitis. 

Patients were categorized based on the timing of their surgical intervention—those who underwent cholecystectomy during a weekend versus those admitted over the weekend but operated on a subsequent weekday. A total of 15,730 patients met the inclusion criteria, and postoperative complications were recorded in 2,246 cases (14.3%). Comparative analysis revealed no statistically significant difference in complication rates between the two groups (14.0% in weekend surgeries vs. 14.5% in weekday surgeries; P = .365), suggesting that performing cholecystectomy over the weekend does not pose additional risk to patients. Interestingly, the proportion of open surgeries was higher among patients operated on during weekends (29.1% vs. 26.3%), with a statistically significant odds ratio of 1.32 (P < .001), indicating a slightly greater tendency toward non-laparoscopic approaches on weekends. 

However, weekend surgeries were associated with shorter operative durations, as procedures lasting more than two hours were significantly less frequent in this group (32.7% vs. 46.8%; P < .001), and the adjusted odds ratio for extended surgery duration was 0.69. These findings may reflect differences in case selection, surgical planning, or operative team availability across days of the week. Overall, the study demonstrates that early cholecystectomy for acute cholecystitis can be safely and effectively performed on weekends, without increasing the risk of postoperative complications. These results challenge the traditional reluctance to operate during off-hours and support the incorporation of early surgical intervention into weekend care protocols, especially in healthcare systems where delays may prolong hospital stays or exacerbate disease progression. Ensuring consistent surgical standards and resource allocation throughout the week may further enhance outcomes and reduce variability in patient care.

Source: surgjournal.com/article/S0039-6060(24)01006-7/fulltext