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Related Experiment Videos

Appendicectomy at cholecystectomy--an appraisal.

D R Donaldson, K Jones, D A Aubrey

    The British Journal of Clinical Practice
    |January 1, 1989
    PubMed
    Summary

    Incidental appendicectomy during biliary surgery showed no increased complications. Routine antibiotic prophylaxis supports removing the appendix during cholecystectomy if accessible, given high pathology rates.

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    Area of Science:

    • Gastroenterology and Hepatology
    • Surgical Pathology

    Background:

    • Elective biliary surgery frequently involves patients where incidental appendicectomy is a consideration.
    • The clinical significance of incidental appendicectomy in this patient cohort remains debated.

    Purpose of the Study:

    • To prospectively evaluate the impact of incidental appendicectomy on patient outcomes during elective biliary surgery.
    • To assess the incidence of appendiceal pathology in incidentally removed appendices.

    Main Methods:

    • A prospective study involving 430 patients undergoing elective biliary surgery.
    • Comparison of outcomes between patients who underwent incidental appendicectomy (n=236) and those who did not (n=194).
    • Outcomes assessed included septic complications, general complications, and hospital stay. Histological examination of removed appendices.

    Main Results:

    • No significant differences in septic complications (including wound infections), general complications, or mean hospital stay were observed between the groups.
    • Histological examination revealed significant pathology in over 50% of macroscopically normal appendices.
    • Routine antibiotic prophylaxis was a key consideration in the analysis.

    Conclusions:

    • Incidental appendicectomy during elective biliary surgery, with appropriate antibiotic prophylaxis, does not increase patient morbidity.
    • The high rate of underlying appendiceal pathology supports the consideration of incidental appendicectomy when the appendix is accessible during cholecystectomy.

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