value of routine appendectomy during cholecystectomy operation

ABSTRACT

The value of incidental appendicectomy during cholecystectomy has been studied prospectively in 128 patients over a 4 years period. Incidental appendicectomy was performed for 80 patients together with the main cholecystectomy operation, whereas cholecystectomy alone was performed for the rest 48 patients. Appendicectomy technique was standardized and prophylactic antibiotics were administered together with drains for high risk patients and randomly for other patients. No mortality nor intraabdominal sepsis were reported. Postoperatively, wound sepsis was more observed in patients who had undergone appendicectomy whether antibiotics were dispensed or not and that was attributed mostly to risk factors e.g. old age, diabetes, acute cholecystitis, drains or positive bile culture rather than the appendicectomy procedure itself. Patients without risk factors did not show specific difference regarding the sepsis rate and mean post-operative stay. Histopathologically, macroscopically normal appendices showed a surprising incidence of abnormal findings [41.3%]. Thus, we recommend routine incidental appendicectomy at the time of cholecystectomy whenever the appendix is readily accessible and patients with risk factors should be protected by antibiotics