PROPHYLACTIC APPENDICECTOMY DURING ELECTIVE CHOLECYSTECTOMY: EFFECTS ON MORBIDITY; FREQUENCY OF PATHOLOGIC ABNORMALITIES. | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 21, Issue 1, January 2002, Page 820-827 PDF (644.9 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2002.375157 | ||||
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| Authors | ||||
| Ahmed Mohamed El-Morsy* 1; Magdy Mourad Mansy2 | ||||
| 1Surgical department El-Matareya Teaching Hospital. Head of sergical Department at Manshieyet El Bakry General Hospital, | ||||
| 2Professor of Pathology, Kasr El Aini Faculty of Medicine | ||||
| Abstract | ||||
| In this prospective controlled study, prophylactic appendicectomy was performed on “45” consenting patients undergoing straightforward elective cholecystectomy (group A). The control group (group B) consisted of “55” patients undergoing elective cholecystectomy alone. All patients received a single I.V. dose of one gm. of Cefazolin Sodium and 500 mg of Metronidazole. The overall wound sepsis rate in group A was 6.7% (in obese 8.7%, and in non obese 4.5%). But in group B, it was 7.3% (in obese 8.8%, and in non-obese 4.8%). No mortality and no residual intraperitoneal sepsis in the study. The mean duration of postoperative hospital stay in group A was 3.35 days, and 3.38 days in group B. The mean operative time was 65 minutes in group A and 58 minutes in group B. Forty percent (18 of 45) of the appendices removed had a significant pathologic changes: Lymphoid hyperpharia (8), Fibrofatty infiltration (4), Acute inflammation (2), Mucocele (2) and Parasitic infestation (2). Appendiceal Fecolith (3) and Kinking (2) were macroscopic pathologic findings. The conclusion of this study is that: prophylactic appendicectomy is “BENEFICIAL” during elective cholecystectomy and can be performed safely provided that it is done with adequate exposure from the same incision of the original procedure, without undue manipulation and the patient is protected with an effective prophylactic antibiotic regimen. Also, routine histopathologic examination of appendicectomy specimens should be emphasized as unsuspected but treatable pathology may be detected. | ||||
| Keywords | ||||
| Prophylactic appendicectomy; Incidental appendicectomy; Routine appendicectomy; Postoperative sepsis; Cholecystectomy and Appendicectomy | ||||
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