Concomitant cholecystectomy for asymptomatic cholelithiasis
L. E. Bragg and J. S. Thompson
Surgical Service, Omaha Veterans Administration Medical Center, NE.
The outcome of 68 patients with asymptomatic cholelithiasis undergoing
laparotomy for other conditions was reviewed to determine those most likely
to become symptomatic postoperatively. Thirty-seven patients (54%) became
symptomatic postoperatively. Eight patients (22%) required cholecystectomy
within 30 days of operation or within the same hospitalization. These
patients fasted for a longer period of time postoperatively (15 +/- 21 vs 4
+/- 3 days) than those undergoing later cholecystectomy. Significantly more
of these patients required transfusion (38% vs 7%), mechanical ventilation
(50% vs 11%), and total parenteral nutrition (50% vs 18%). Cholelithiasis
frequently becomes symptomatic after laparotomy for other intra-abdominal
conditions. Patients who require mechanical ventilation, transfusions, and
parenteral nutrition and who are slow to resume enteral nutrition are more
likely to require early cholecystectomy. Concomitant cholecystectomy adds
minimal morbidity to other procedures and should be undertaken unless
specific contraindications exist, particularly in this high-risk group.