Concept: When to Remove the Gallbladder

  • Jameson L. Chassin

Abstract

Despite the potential risk of surgical errors, which may produce complications of a horrendous nature, cholecystectomy in the hands of a skilled surgical team is followed by a remarkably low mortality rate. In a review of 1,100 cholecystectomies without common bile duct (CBD) exploration performed (1969–1980) for nonmalignant gallbladder disease, including acute cholecystitis, by the residents and staff of the Booth Memorial Medical Center in Flushing, New York, the hospital mortality was 0.25%. Martin and van Heerden reported a 0.3% rate for 586 cholecystectomies for chronic cholecystitis and 2.1% for acute cholecystitis. McSherry and Glenn found a 0.5% hospital mortality rate following cholecystectomy for chronic disease of the biliary tract; in patients under age 50 the mortality rate was 0.1 %, while those over age 50 experienced a rate of 0.9%.

Keywords

Acute Pancreatitis Common Bile Duct Cystic Duct Acute Cholecystitis Common Bile Duct Stone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gracie WA, Ranshoff DF. The natural history of silent gallstones. N Engl J Med 1982;307:798.PubMedCrossRefGoogle Scholar
  2. Jarvinen HJ, Hastbacka J. Early cholecystectomy for acute cholecystitis. Ann Surg 1980; 191:501.PubMedCrossRefGoogle Scholar
  3. Martin JK Jr, van Heerden JA. Surgery of the liver, biliary tract, and pancreas. Mayo Clin Proc 1980;55:333.PubMedGoogle Scholar
  4. McSherry CK, Glenn F. The incidence and causes of death following surgery for non-malignant biliary tract disease. Ann Surg 1980; 191:271.PubMedCrossRefGoogle Scholar
  5. Paloyan D, Simonowitz D, Skinner DB. The timing of biliary tract operations in patients with pancreatitis associated with gallstones. Surg Gynecol Obstet 1975;141:737.PubMedGoogle Scholar
  6. Ranson JHC, Rifkind KM, Roses DF, Fink SD et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974; 139:69.PubMedGoogle Scholar
  7. Ranson JHC. The timing of biliary surgery in acute pancreatitis. Ann Surg 1974; 189:654.CrossRefGoogle Scholar
  8. Soper NJ, Stockman PT, Dunnegan DL et al. Laparoscopic cholecystectomy: the new “gold standard”? Arch Surg 1992;127:917–923.PubMedCrossRefGoogle Scholar
  9. Tondelli P, Stutz K, Harder F et al. Acute gallstone pancreatitis: best timing for biliary surgery. Br J Surg 1982;69:709.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
  1. 1.Clinical SurgeryNew York University School of MedicineNew YorkUSA
  2. 2.Department of SurgeryNew York Hospital Medical Center of QueensFlushingUSA

Personalised recommendations