Incidental cholecystectomy--an old problem reconsidered

This paper reexamines the issues and indications for incidental cholecystectomy when gallstones are present during laparotomy for an unrelated condition. Seventy-nine such patients were studied between 1988 and 1993--66 had incidental cholecystectomy (both elective and emergency) while asymptomatic gallstones were left alone in 13 patients for various reasons. There was little morbidity and no mortality arising directly from biliary surgery. Interestingly, four bile cultures from the asymptomatic gallbladders grew bacteria and this could explain why patients may develop severe disease postoperatively if their gallbladders were left alone. The added cholecystectomy resulted in an acceptable extension of 22 to 23 minutes in the operative time without compromising the patients' safety.