ASYMPTOMATIC GALLSTONES - WHAT TO DO IN PATIENTS UNDERGOING COLONIC SURGERY FOR CANCER

Twenty-three patients who underwent elective surgery for colorectal ca ncer in our hospital between 1983 and 1989, underwent concomitant chol ecystectomy for asymptomatic gallstones. In order to assess whether ad ditional cholecystectomy increases postoperative morbidity and mortali ty, a comparison was made between these cases and 23 controlled patien ts (without gallstones) matched for sex, age (+/- 3 years), Dukes stag e and type of primary colonic surgery. The duration of postoperative s tay was similar in the two groups (14.1 +/- 4.5 days vs 12.4 +/- 2.3 d ays). Postoperative complications were more frequent among the case pa tients than among the controls (34.8% vs 8.7%, p = 0.04), and the same was true for the mortality (8.7% vs 0%). During the same period, anot her 11 patients with asymptomatic cholelithiasis were operated on for colorectal cancer but in these patients gallstones were left in place. Two of the patients died postoperatively and only one of the remainin g 9 (11.2%) had an episode of biliary pain. The results of our study w ould suggest that in patients undergoing surgery for colorectal cancer the risk entailed in carrying out an additional cholecystectomy for a symptomatic gallstones is greater than the risk of future morbidity ca used by gallstones left in place.