The results of cholecystectomy at a district general hospital. A reappraisal of operative cholangiography.

A total of 487 cholecystectomies were performed at one hospital over a 44-month period by surgeons who differed considerably in the frequency with which they performed operative cholangiography. There were no differences in the frequency or severity of postoperative complications or recurrent symptoms between patients who did and those who did not undergo operative cholangiography; nor were any differences demonstrable between patients operated on by different surgeons. Although it is established that operative cholangiography will demonstrate otherwise unsuspected common bile duct stones in some patients, it has not yet been clearly proved that these stones would cause later complications if left undisturbed. The clinical advantages of operative cholangiography are not sufficiently clear to preclude their assessment by prospective controlled studies involving large numbers of patients.