Combined colonic and biliary surgery: assessment of risk in elderly patients

From 1982 to 1986, routine preoperative ultrasound examination of the gallbladder and the liver was performed in all patients undergoing colonic surgery. A decision was made to do a cholecystectomy and intraoperative cholangiography when gallstones were found preoperatively. According to this prospective protocol, 20 patients had biliary surgery performed in conjunction with colonic resection. The mean age of these patients was 70 years (median, 70 years; range, 53-83 years). There was no death in this study group and only three nonfatal complications. Despite the fact that our operative strategy increases the average duration of the operation, it avoids the risk of postoperative cholecystitis and the possible need for a second operation in these elderly patients.