Incidental cholecystectomy during major abdominal surgery in the elderly

When cholelithiasis and gastroduodenal disease coexist, the surgeon must decide whether it is appropriate to perform a cholecystectomy at the same time as gastric surgery. The decision should be based on whether simultaneous cholecystectomy increases the risk of gastric surgery. We examined 38 patients who had undergone gastric resection or total gastrectomy and simultaneous cholecystectomy, and 38 patients who had undergone gastric surgery without cholecystectomy during the same period of time, who served as matched controls. The two groups were compared with respect to duration of operation, plasma and blood units transfused during and after surgery, duration of postoperative hospital stay, postoperative complications and mortality. Results regarding the two groups were compared by statistical tests. Analysis of the results did not reveal any significant differences between cases and controls, but the power of the test was quite low (1-β = 0.4). The results thus do not allow any final conclusion, but they would seem to support the possibility that simultaneous cholecystectomy does not increase the risks of gastric surgery.

Section: Discussionmentioning

confidence: 41%

Section: Introductionmentioning

confidence: 99%

Does Cholecystectomy Increase the Risks of Gastric Surgery?

Sarli¹,

Gafà²,

Sansebastiano

et al. 1989

“…The operative removal o f a pathological, usually stone bearing gallbladder discovered either prior to or during laparotomy for other cause is known as incidental chole cystectomy and is the subject o f some controversy [1][2][3][4][5][6]. The issue has an increasing importance in the geriatric age group in which the incidence o f gallstones is estimated to be high and the decision and dilemma involved may, therefore, occur with increasing frequency [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Incidental Cholecystectomy Does Not Increase the Risk of Surgery for Gastrointestinal Malignancy

Watemberg¹,

Avrahami²,

Landau³

et al. 1995

From 1975 to 1994, 291 incidental cholecystectomies were performed in our department, 143 of them during surgery for gastrointestinal tumors. The number of incidental cholecystectomies has increased gradually each year, mainly after preoperative sonographic screening of the gallbladder became routine in our department. We have found that mortality, morbidity and duration of surgery were not significantly influenced by the addition of incidental cholecystectomy. The risk of the gallbladder becoming symptomatic during the expected survival of the patients who were operated upon for gastrointestinal tumors is higher than the added risk, morbidity or mortality as well as additional cost of incidental cholecystectomy. Therefore, the authors recommend the performance of incidental cholecystectomy during elective laparotomies for gastrointestinal tumors.

“…While numerous articles were published on the natu ral history of lithiasic biliary disease [3][4][5][6] and on the opportuneness of surgically treating asymptomatic gall stones [3,[7][8][9], few indications exist in the literature regarding the risks involved in carrying out cholecystec tomy at the same time as surgery for digestive disease [10,11] and in particular disease of the colon [12]. Shemib et al [12] conclude that cholecystectomy com bined with colonic surgery is to be recommended if the operation is carried out under elective conditions.…”

mentioning

confidence: 99%

Does Cholecystectomy Increase Operative Risk of Colonic Surgery?

Sarli¹,

Gafà²,

Pietra³

et al. 1987

Little has been written about the risk of cholecystectomy combined with colonic surgery. We have carried out a prospective matched case-control study on 39 patients who had undergone colonic resection and simultaneous cholecystectomy and on 39 patients who had undergone colonic resection alone who served as matched controls. The two groups were compared with respect to the duration of surgery, plasma and blood units transfused during and after surgery, duration of postoperative hospital stay, postoperative complications and mortality. Statistical analysis of the results did not reveal any significant differences between the two groups and seem to exclude the possibility that simultaneous cholecystectomy increases the risks of colonic resection. This leads us to conclude that, when gallstones – even if asymptomatic – and colonic disease are associated, cholecystectomy can be performed during colonic resection.