{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:09:52Z","timestamp":1789063792525,"version":"build-2803163510"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Competition for urgent and emergent operating-room access is a significant challenge in many hospitals. Evidence-based benchmarks for early intervention are well established for emergencies like acute appendicitis or hip fracture. In contrast, laparoscopic cholecystectomy for acute cholecystitis or symptomatic cholelithiasis is often delayed. The purpose of this study was to evaluate the clinical and economic impact of delays in laparoscopic cholecystectomy across the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Nationwide Readmissions Database was queried for patients aged \u226518\u00a0years admitted between 2021 and 2022 undergoing urgent or emergent laparoscopic cholecystectomy. Patients were stratified based on operative timing (&lt;3 vs \u2265 3\u00a0days). The primary outcome was 30-day readmission. Secondary outcomes included VTE, SSI, and total cost. Propensity score matching (1:1) was performed using 46 covariates. Linear regression assessed the cost associated with each additional hospital day prior to surgery, with a subgroup analysis of safety-net hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 136,893 patients, 24,496 (17.9%) experienced delayed laparoscopic cholecystectomy. After matching (n = 48,992), delays were associated with increased odds of readmission (9.5%; OR 1.22 [1.15-1.29],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and VTE (1.5%; OR 1.51 [1.30-1.77],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). SSI (0.2%) was not significantly different. The mean total cost was $25,957 \u00b1 $21,609 for delayed patients vs $20,784 \u00b1 $20,027 for early surgery. Linear regression revealed an incremental cost of $1,695 per additional hospital day prior to surgery, rising to $2071 per day in safety-net hospitals (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Delays in laparoscopic cholecystectomy have significant clinical and economic impacts, underscoring the urgent need for national benchmarks to standardize operative timing and reduce disparities for patients in safety-net hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261486928","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:55:36Z","timestamp":1788879336000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Cholecystectomy Is a Time-Sensitive Operation: National Outcomes Associated With Delayed Surgery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-8292","authenticated-orcid":false,"given":"Himani","family":"Bhatt","sequence":"first","affiliation":[{"name":"Memorial Healthcare System"},{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6905-7044","authenticated-orcid":false,"given":"Nancy","family":"Orduno Villa","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant","family":"Kumar","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4799-6557","authenticated-orcid":false,"given":"Deep","family":"Vakil","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahajpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Young","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Curcio","sequence":"additional","affiliation":[{"name":"Department of Surgical Critical Care, HCA Florida Lawnwood Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Parreco","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2012.6.2.172"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(03)00065-9"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480006600921"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a1599b"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001886"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2747-x"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00360-5"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6870"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12449"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000001103"},{"issue":"8","key":"e_1_3_4_12_2","first-page":"e90940","article-title":"Comparison of outcomes of early and delayed laparoscopic cholecystectomies in UK clinical practice: a systematic review","volume":"17","author":"Munir A","year":"2025","unstructured":"Munir A, Osman AM, Galluci A, et al. 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