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April 10, 1981

Cholecystectomy and Abdominal Hysterectomy

Author Affiliations

Southern California Permanente Medical Group Los Angeles

JAMA. 1981;245(14):1410. doi:10.1001/jama.1981.03310390018007

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To the Editor.—  The article "Cholecystectomy and Abdominal Hysterectomy" by Murray et al (1980;244:2305) raises several interesting points of discussion. The fact that the series of 21 cases described by Murray et al and a report by Pratt et al in 1967 of 95 similar combined procedures are the only two such reports in the literature, to my knowledge, suggests that not too many surgeons and gynecologists agree with the wisdom of such an operation.Speaking as a surgeon, my chief objection to this approach is the potential tendency to eliminate an operative cholangiogram or common duct exploration because of the additional time required in an already lengthy operation. Under the usual circumstances of a single procedure, there would be no hesitation in carrying out these important steps when indicated. Time would eventually tell how many common bile duct stones were overlooked.Prophylactic cholecystectomy in asymptomatic patients is justified when