Prospective study of open cholecystectomy for calculous biliary disease

Data of 5000 consecutive patients with biliary lithiasis operated on between 1970 and 1990 were recorded prospectively. There were 476 emergency procedures and 125 reoperations. Concomitant abdominal operations were performed in 504 patients. The mean(s.d.) age was 54.7(14.2) years. Cholecystectomy was performed in 4872 patients (97.4 per cent) and intraoperative cholangiography in 4400 (88.0 per cent). There were 612 operations for acute cholecystitis, 579 for common bile duct stones, 50 for acute pancreatitis and 29 reoperations following injury to the bile duct. Complications occurred in 527 patients (10.5 per cent). There was one injury (0.02 per cent) to the hepatic duct. The complication rate was 7.0 per cent following elective cholecystectomy and 17.4 per cent after emergency surgery. The mortality rate was zero after elective procedures and 0.8 per cent after emergency surgery; the mortality rate after concomitant abdominal operations (1.0 per cent) was unrelated to the biliary procedure. The mean(s.d.) hospital stay was 12.8(5.2) days.