Document Detail


Should cholecystectomy be done en passant for asymptomatic cholelithiasis?
MedLine Citation:
PMID:  3664389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of asymptomatic gallstones discovered during abdominal surgery is controversial. Should cholecystectomy be performed en passant? The authors report a 4-year survey of 109 patients with asymptomatic cholelithiasis who underwent surgery for other abdominal conditions: colorectal (31), gastric (24), vascular (20), gynecologic (21) and miscellaneous (13). Cholelithiasis was established preoperatively by ultrasonography in 52 of 55 examinations (95%). In the other 54, the gallstones were discovered at operation. Cholecystectomy was performed in 78 patients and in 31 the gallbladder was left in place. In the former group, 11 (14%) had complications, 2 being attributable to the cholecystectomy. Intraoperative cholangiograms were obtained in 43 and led to common-bile-duct explorations in 8. Common-bile-duct stones were found in seven. In the non-cholecystectomized group, three died postoperatively and three were lost to follow-up. Twelve of the remaining 25 are still asymptomatic and 13 have had symptoms: 7 underwent cholecystectomy (4 for acute cholecystitis) between 2 weeks and 11 months after the initial laparotomy. Because of the low morbidity and the relatively high number of cholecystectomies that were subsequently necessary, the authors recommend cholecystectomy en passant unless there is a specific contraindication. They also recommend ultrasonography before major gastrointestinal or vascular surgery in order to plan for cholecystectomy.
Authors:
C Saade; D Bernard; S Morgan; D Tassé; A Rabbat; N Nadeau
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  30     ISSN:  0008-428X     ISO Abbreviation:  Can J Surg     Publication Date:  1987 Sep 
Date Detail:
Created Date:  1987-11-23     Completed Date:  1987-11-23     Revised Date:  2007-08-16    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  350-3     Citation Subset:  IM    
Affiliation:
Department of Surgery, Université de Montréal, PQ.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cholecystectomy* / mortality
Cholelithiasis / mortality,  surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Reoperation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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