A STUDY OF CHOLECYSTECTOMY

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Abstract
In a series of 1006 cholecystectomies done between 1934-1953 at Vanderbilt University Hospital, 136 associated choledochotomies were carried out. In each of the 4 successive 5-year periods there was a decrease in hospital stay from 15.2 to 8.3 days, and in post-operative morbidity from 2.1 to 1.2 days following cholecystectomy alone. The added choledochotomy has prolonged hospital stay morbidity and mortality in spite of all the adjunct treatment now available. Post-operative complications causing morbidity were principally related to the pulmonary system, although there were 15 wound infections in the 870 patients having simple cholecystectomy. In addition, in this group there were 2 deaths from sub-diaphragmatic abscess and 5 from peritonitis. Cholecystectomy and associated common duct exploration resulted in various complications in 22% of patients, predominately pulmonary, with an overall mortality of 6.7%. In the last 5-year period the mortality was 3.9%. In the entire series there was no known instance of common duct stricture or of stone left in the duct after simple cholecystectomy. There was a satisfactory improvement in morbidity, mortality, and duration of hospital stay over the 20 years surveyed.

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