Prophylactic appendicectomy during elective cholecystectomy: effects on morbidity. A prospective controlled study.

Prophylactic appendicectomy was performed on 56 consenting patients undergoing elective cholecystectomy. The control group consisted of 60 patients. Both groups were well matched in respect of age, sex, build and type of incision. All patients received a single i.v. dose of 1 g Cefazolin sodium and 500 mg Metronidazole at induction of anaesthesia. Postoperative wound sepsis occurred in 5.4% of the appendicectomy group and in 6.7% of the control group. Residual intra-abdominal sepsis did not occur in either group. The mean duration of postoperative hospital stay was 9.1 days (SD +/- 1.63) in the appendicectomy group and 8.5 days (SD +/- 1.85) in the control group. These differences were not statistically significant. Six (10.7%) of the appendices removed were abnormal, including two with inflammation. The conclusion of this study is that prophylactic appendicectomy can be performed safely during elective cholecystectomy provided that it is done without undue manipulation and the patient is protected with an effective prophylactic antibiotic regimen.