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Prophylactic appendicectomy during elective cholecystectomy: effects on morbidity. A prospective controlled study.

T A el-Sefi1, H M el-Awady, M I Shehata

  • 1Department of Surgery, A.O.C. Hospital, Al-Khafji, Saudi Arabia.

International Surgery
|January 1, 1989
PubMed
Summary

Performing prophylactic appendicectomy during elective cholecystectomy is safe and does not increase infection risk or hospital stay. This procedure can identify abnormal appendices, improving patient outcomes.

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Area of Science:

  • Surgical Procedures
  • Infectious Disease Prevention
  • Gastrointestinal Surgery

Background:

  • Elective cholecystectomy is a common surgical procedure.
  • Appendicitis is a frequent cause of abdominal pain, necessitating appendectomy.
  • The potential benefits and risks of prophylactic appendicectomy during other abdominal surgeries are not fully established.

Purpose of the Study:

  • To evaluate the safety and efficacy of prophylactic appendicectomy during elective cholecystectomy.
  • To compare postoperative complication rates, including wound sepsis and intra-abdominal sepsis, between patients who underwent prophylactic appendicectomy and a control group.
  • To assess the impact of prophylactic appendicectomy on the duration of postoperative hospital stay.

Main Methods:

  • A prospective study involving 56 patients undergoing prophylactic appendicectomy concurrently with elective cholecystectomy.

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  • A control group of 60 patients undergoing elective cholecystectomy without appendicectomy.
  • Both groups received standardized prophylactic antibiotics (Cefazolin sodium and Metronidazole) and were matched for demographic and surgical factors.

    • Main Results:

    • Postoperative wound sepsis rates were similar: 5.4% in the appendicectomy group versus 6.7% in the control group.
    • No instances of residual intra-abdominal sepsis were observed in either group.
    • The mean postoperative hospital stay was comparable (9.1 days vs. 8.5 days), with no statistically significant difference.

    Conclusions:

    • Prophylactic appendicectomy can be safely performed during elective cholecystectomy.
    • The procedure is safe when conducted with minimal manipulation and supported by effective prophylactic antibiotic regimens.
    • A small percentage (10.7%) of removed appendices were abnormal, indicating potential diagnostic value.