[Cholecystectomies at the Saint-George Hospital. Apropos of 672 operations performed, 1982-1991]

In a retrospective study of a 10-year period (1982-1991), the results of 672 consecutive operations for cholecystectomy were analyzed. 67.7% were females and the medium age was 54.4%. Ultrasound is used to be the test of choice and surgery was done for chronic cholecystitis in 79.9% and in 20.1% for acute cholecystitis. With an overall mortality rate of 1.9% and a morbidity of 16%, conventional cholecystectomy proved to be a safe method. Mortality and morbidity seem to be related to age (> 60 years, median age 70.5), sex (men = 70%), and associated procedures (choledochotomy with exploration, sphincterotomy, biliary derivation). Systematic antibiotic prophylaxis and non drainage of the sub-hepatic area in certain cases lowered the incidence of wound infection, and improved post-operative course. Selective operative cholangiogram also improved per and post-operative course and does not seem to increase the incidence of residual stones. Now, only the new laparoscopic cholecystectomy may represent the alternative to the ideal treatment of cholecystolithiasis.