Indications for cholecystectomy in ligation of the hepatic artery.

Ligation of the hepatic artery has been successfully used in the management of massive bleeding, secondary to hepatic trauma, and in the treatment of metastatic neoplastic disease. The indications for a concomitant cholecystectomy are less well defined. It is generally accepted that cholecystectomy should be performed when ligation is used to control bleeding. In our study, ligation of the hepatic artery was performed, leaving the gallbladder in situ. At autopsy, no pathologic process could be detected in the gallbladder. Microscopic analysis showed fibrosis in the mucosal surface, mild chronic inflammation and nonspecific mononuclear infiltration. We conclude that the changes are insufficient to warrant the removal of a normal gallbladder when ligation of the hepatic artery is performed as treatment for neoplastic disease.