RECENT TRENDS IN GALLBLADDER SURGERY

Abstract

One cannot say that any remarkable discoveries have been announced during the past several years in any phase of gallbladder disease, but certain advancements have gradually been made. For example, the belief that cholecystitis starts primarily as a chemical lesion has become more and more prevalent. Supporting evidence for this hypothesis is available in the fact that cultures of the bile and wall of the gallbladder in cholecystitis are so often negative. I am convinced that the infectious phase of cholecystitis is usually superimposed on an initial chemical inflammation. The role of infection in gallbladder disease has definite clinical significance, particularly in cases of fulminating acute cholecystitis when there may be indecision as to whether cholecystectomy or cholecystostomy should be performed. When systemic reaction is severe, the demonstration of numerous bacteria in a smear made from bile aspirated from the gallbladder at the operating table may correctly indicate the performance