Interval cholecystectomy: an appraisal.

Abstract

Interval cholecystectomy (IC), the removal of a diseased gallbladder after drainage for acute infection, is considered an appropriate procedure in suitable patients. While increased technical problems can be expected, other potentially serious complications are frequently overlooked. This review, prompted by difficulties during IC, compares multiple parameters (eg, technical difficulties, morbidity, postoperative convalescence) between this group and "routine" gallbladder operations (RC). During the period between 1970 and 1979, 224 patients with gallbladder disease were operated upon at this Veterans Administration Medical Center. Included among these were seven patients who required cholecystostomy, five of whom were treated by subsequent IC. When compared to the RC group, IC was usually done in older patients and was technically more difficult, as evidenced by longer operating times and increased operative blood loss. In addition, this group's postoperative convalescent period was significantly prolonged because of an increased rate of complications, wound infections being the most common. These were believed to be responsible for the two deaths in this group (the only deaths in the entire RC-IC group.