[Combined operations in cholelithiasis]

Experience in combined operations for cholelithiasis on 162 patients is discussed. In 98 patients, cholecystectomy was performed as a simultaneous stage of surgical treatment, the main stage of the operation was gastrectomy or resection of the stomach for cancer in 26 patients, formation of a small stomach for alimentary-constitutional obesity in 19, various types of vagotomy in 33, hemicolectomy, resection of the colon and sigmoid intestine for malignant tumors in 10, and reconstructive manipulations on the stomach, correction of intestinal obstruction, and other operations in 10 patients. Cholecystectomy was the main stage of the operation in 48 patients with hernias, benign tumors of the uterine appendages, breasts, and soft tissues. The authors insist that cholecystectomy must be carried out when cholelithiasis is a concurrent disease; they showed that increase in the extent of the operative intervention had no essential effect on mortality and frequency of postoperative complications (mortality rate, 1.2%). The authors substantiate the expediency of performing combined operations from economical considerations--the economical effect of the operations conducted by the authors came to some 51,000 roubles.