Surgery for gallbladder disease in Ohio: A survey of 3,085 operations

1. 1. A survey of 3,085 operations performed for nonneoplastic gallbladder disease in thirty hospitals in eighteen communities in Ohio during 1959 is reported. 2. 2. Of the patients 74 per cent were white women. 3. 3. Preoperative x-ray films had an accuracy of 95 per cent in predicting stones in the gallbladder. 4. 4. Common duct exploration in patients with jaundice of any type yielded stone in 61 per cent, without jaundice in 38 per cent. 5. 5. Operative cholangiography was used prior to opening of the common duct in 24 per cent of the patients and was the most accurate indication of stones in the common duct, aside from a small group in which common duct stones were palpated. 6. 6. Mortality showed a progressive climb in the older age groups, reaching 16 per cent in those patients eighty years old and over. There were no deaths below the age of forty. 7. 7. The over-all mortality was .78 per cent for elective and 9.0 per cent from emergency operations. 8. 8. The mortality from cholecystectomy was sixteen times greater when performed as an emergency. 9. 9. Mortality from common duct exploration was approximately six to seven times greater when performed as an emergency. 10. 10. The lowest mortality (0.9 per cent) occurred in the group operated upon by Fellows of The American College of Surgeons, who were Board Certified. The over-all mortality in the entire group was 1.2 per cent.