Appendicectomy at cholecystectomy--an appraisal

The effect of incidental appendicectomy in patients undergoing elective biliary surgery has been studied prospectively in 430 patients. In 236 patients the appendix was removed at the time of biliary surgery; in 194 patients the appendix was not removed or had already been removed at a previous operation. There was no significant difference between the two groups with regard to the incidence of septic complications--especially wound infection--more general complications, or in the mean post-operative stay in hospital. Histological examination of the macroscopically normal appendices revealed a surprising incidence of pathology (greater than 50 per cent). Provided the patient receives routine antibiotic prophylaxis, there appears to be a case for removing the appendix at the time of cholecystectomy if it is readily accessible.