Cholecystectomy concomitant with other intra-abdominal operations. Assessment of risk.
In a retrospective study, 1,416 cholecystectomies performed during a three-year period were reviewed to define the risk of cholecystectomy when combined with another intra-abdominal procedure. Group 1, cholecystectomy alone (1,148 patients), with subsets of cholangiography and/or common bile duct exploration, had a complication rate of 14.29% and a mortality of 0.52%. Group 2, primary cholecystectomy combined with secondary intra-abdominal surgery (214 patients), had a complication rate of 19.63%. Group 3, primary intra-abdominal surgical procedure with incidental cholecystectomy (54 patients), had a complication rate of 20.37%. Mortality for groups 2 and 3 was 2.24%. The rate of nonfatal complications was increased slightly when a second surgical procedure was performed (14.29% v 19.78%). Pairing cholecystectomy with other intra-abdominal surgery is advised only when surgical exposure is adequate, the patient's condition is satisfactory, and operating time is not prolonged greatly.
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002758:Cholangiography; D002763:Cholecystectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk