Cholecystectomy concomitant with other intra-abdominal operations. Assessment of risk.

In a retrospective study, 1,416 cholecystectomies performed during a three-year period were reviewed to define the risk of cholecystectomy when combined with another intra-abdominal procedure. Group 1, cholecystectomy alone (1,148 patients), with subsets of cholangiography and/or common bile duct exploration, had a complication rate of 14.29% and a mortality of 0.52%. Group 2, primary cholecystectomy combined with secondary intra-abdominal surgery (214 patients), had a complication rate of 19.63%. Group 3, primary intra-abdominal surgical procedure with incidental cholecystectomy (54 patients), had a complication rate of 20.37%. Mortality for groups 2 and 3 was 2.24%. The rate of nonfatal complications was increased slightly when a second surgical procedure was performed (14.29% v 19.78%). Pairing cholecystectomy with other intra-abdominal surgery is advised only when surgical exposure is adequate, the patient's condition is satisfactory, and operating time is not prolonged greatly.