MacLean L D, Goldstein M, MacDonald J E, Demers R
Can J Surg. 1975 Sep;18(5):459-65.
Analysis of the results of cholecystectomy in 1000 consecutive patients revealed an overall mortality of 0.6%; among patients who underwent cholecystectomy only, there were no deaths. Wound infection occurred in 3.4% of all patients but the rate exceeded 8% among those in whom another procedure was performed or there was acute cholecystitis. Cephaloridine given prophylactically was useful in decreasing the infection rate in the two latter groups. Cystic duct cholangiography, used in 193 patients, increased the rate of stone retrieval from the bile ducts from 41 to 63%, but the incidence of both false-negative and false-positive cholangiograms was disturbingly high. Exploration was performed on clinical grounds despite a normal cholangiogram in 15 patients, with 5 positive results. Common duct exploration was productive 41% of the time when clinical judgement without cholangiography was used. While cystic duct cholangiography is useful, improvements in reliability are imperative and probably feasible, in view of the results achieved in the operating room and those in departments of radiology.