Open cholecystectomy

The experience with "open" biliary tract surgery is documented in this report in an effort to provide a basis for comparison with the more recent experience with laparoscopic cholecystectomy. During the years 1932 through 1984, 14,232 patients were surgically treated for nonmalignant biliary tract disease at The New York Hospital-Cornell Medical Center. Among these patients, the mortality rate was 1.7% (237 postoperative deaths). Cholecystectomy was performed in 10,749 patients, and the mortality rate was 0.6% (60 postoperative deaths). Of this group of patients, chronic cholecystitis was present in 8,910 patients, and the mortality rate was 0.4% (38 postoperative deaths). Acute cholecystitis was present in 1,839 patients, and the mortality rate was 1.2% (22 postoperative deaths). Choledochotomy as a component of the primary biliary tract operation was performed in 2,226 patients (15.6%), and there were 89 postoperative deaths (4%). In the last 6 years of this study (1978 through 1984), 1,693 patients underwent cholecystectomy alone, and the mortality rate was 0.2% (3 postoperative deaths).