Safety of cholecystectomy with abdominal aortic surgery.

Many surgeons are reluctant to remove asymptomatic gallstones during aortic reconstruction for fear of increasing the risk of graft infection. This is a review of 56 patients who underwent aortofemoral bypass or aortic aneurysm repair, with cholecystectomy, to determine if the morbidity or mortality was increased with the concomitant procedure. Follow-up averaged 25 months (range from 1 to 125 months). Three patients were lost to follow-up. Operative and postoperative hospital stay were not increased. One patient suffered a graft infection and a pseudoaneurysm; the infection was not related to the cholecystectomy since it occurred after a secondary procedure for repair of an infected false aneurysm. There were three superficial infections and three postoperative deaths, none of which specifically related to the cholecystectomy. The only related complications were three bile leaks, one liver injury due to a retractor and bleeding from the gallbladder bed in one patient who required reoperation. The authors conclude that concomitant cholecystectomy can be performed without increased risk to the patient but is advised only if the vascular procedure has been uncomplicated and the cholecystectomy appears straightforward.