Comparative incidence of stones in the common duct in acute and chronic cholecystitis (and their relationship to the number of calculi in the gallbladder)

Abstract

Calculi in the common duct occur 60 per cent more often in patients with acute cholecystitis and multiple calculi than in patients with chronic cholecystitis and multiple calculi. Of 122 patients with acute cholecystitis and multiple calculi in the gallbladder, twenty-four (19.7 per cent) had associated stones in the common duct. Of 282 patients with chronic cholecystitis and multiple calculi in the gallbladder, thirty-five (12.4 per cent) had calculi in the common duct. Therefore, the status of the common duct is more important, and its exploration by incision or by operative cholangiography or by both is more essential in patients with acute cholecystitis than in patients with chronic cholecystitis. No patient with a solitary calculus in the gallbladder (thirty-seven or 23.3 per cent of patients with acute cholecystitis and fifty-five or 16.3 per cent of those with chronic cholecystitis) had associated stones in the common duct. Calculi in the common duct occur more often in patients with acute calculus cholecystitis than in patients with chronic calculus cholecystitis. When multiple calculi exist in the gallbladder, the difference is even more striking.