title: Cholecystectomy During the Weekend Increases Patients' Length of Hospital Stay.
abstract: BACKGROUND
  A higher risk of complications and mortality has previously been proven in selected settings. The purpose of this study was to investigate whether length of stay differentiates throughout the week and register if intra- and postoperative complications vary on weekends compared to weekdays.
  
  
  METHODS
  The population originated from the Danish Cholecystectomy Database. It consists of adult patients, who had a cholecystectomy performed by standard four-port laparoscopic or open surgery. Adjusted analyses were used to study if day of the week had an influence on conversion, readmission within 30 days, post-operative supplemental procedures within 30 days, and variance in postoperative length of stay across the week.
  
  
  RESULTS
  A total of 28,759 patients were included in the study. We found no difference in conversion rate, readmission within 30 days, or post-operative procedures within 30 days between week time and weekend time. A longer postoperative length of stay was observed for patients operated on Fridays and Saturdays even though surgical complication rates were alike between weekdays. Patients with acute cholecystitis had a longer length of stay on Saturdays.
  
  
  CONCLUSIONS
  We found no evidence of a higher risk of conversions, post-operative procedures, or readmission during weekends compared with weekdays. Despite this, a prolonged length of stay was observed in patients operated with cholecystectomy on Fridays and Saturdays. The observed difference could be due to ward rounds on weekends mainly focus on the sickest patients leaving less time for discharge.
authors.affiliation: Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Copenhagen, Denmark. josephineprothman@gmail.com.
authors.forename: Josephine Philip
authors.identifier: http://orcid.org/0000-0002-7301-2702
authors.initials: JP
authors.lastname: Rothman
authors.affiliation: Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Copenhagen, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.affiliation: Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Copenhagen, Denmark.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.affiliation: Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Copenhagen, Denmark. josephineprothman@gmail.com.
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D000368:Aged; D002763:Cholecystectomy / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D041881:Cholecystitis, Acute / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D012042:Registries; D013997:Time Factors