Factors pertinent to the reduction of the mortality in cholecystectomy

Conclusions

There are certain axioms in gall bladder surgery which if adhered to, will in my opinion, reduce the mortality.

These are:

• 1. An intimate knowledge of the common and special anatomy of the bile passage-ways.

• 2. Spinal anesthesia because of the relaxation it affords, has greatly reduced the mortality.

• 3. Glucose and blood transfusions before and after operations are of great value.

• 4. Do not operate as an emergency on acute cases.

• 5. Put the stomach and intestinal tract at absolute rest.

• 6. Do not explore the common duct unless there is some very good reason.

• 7. The less we institute drainage, at operation, the better.

• 8. Never perform a cholecystectomy in the presence of jaundice.

• 9. Whenever possible remove the gall bladder within in its peritoneal fold.