Complete abdominal exploration is unnecessary during the treatment of cholelithiasis

The development of laparoscopic and non-operative methods for the management of cholelithiasis has been based on the premise that abdominal exploration during cholecystectomy is unnecessary. In the current study, 305 patients undergoing complete abdominal exploration during routine cholecystectomy were evaluated to assess the incidence and significance of intraabdominal pathology found at the time of exploration. While 41 patients (13.4%) were found to have additional diagnosis at the time of exploration, the majority of these were either minor in nature or would easily have been recognized utilizing laparoscopic techniques. Only one patient would have had significant intraabdominal pathology missed by laparoscopic techniques. It can be concluded that abdominal exploration at the time of treatment of cholelithiasis is unnecessary and that laparoscopic cholecystectomy will not compromise patient care in this regard.