IntroductionThe prevalence of gallstones approaches 9 % in > 60 year olds, accounting for 5.5 million in the UK that effectively results in 50,000 cholecystectomies per year. Since its introduction, laparoscopic cholecystectomy has been universally adopted as the preferred surgical technique. The mortality associated with cholecystectomy remains low at 0.1 % in laparoscopic and 0.5 % in open techniques. The aim of the study is to identify the risks associated with early cholecystectomy deaths. Materials & methods26 cholecystectomy deaths since 1995 and a control group of 457 live cholecystectomies since 2004 were entered into the study. The descriptive demography and surgical outcome between the live and deceased group were evaluated. Data is presented as mean ± standard error, and Mann Whitney U test is used with p < 0.05 as being significant. DiscussionCholecystectomy deaths were more common in the open technique, in the acute gallbladder (acute cholecystitis and acute admission), in the elderly, in males and in the marginal patient (high risk patient with significant co-morbidities). Mortality from cholecystectomy arose predominantly from biliary (33.3 %), cardiovascular (20.83 %) and respiratory complications (16.67 %) compounded by sepsis (58.33 %). With progressive improved laparoscopic techniques and equipment and critical care services, the mortality from technical surgical complications have reduced. The marginal patient (high risk) with the acute gallbladder poses a special risk.
Results

	Living (n = 457)	Deaths (n = 26)	Mann Whitney U (p value)
Survival (days)		16.19 ± 4.096
Age (years)	51.99 ± 0.75	70.00 ± 2.179	< 0.05
Sex (M : F)	91 : 366	12 : 14	< 0.05
ASA (median)	2	3	< 0.0001
BMI	29.92 ± 0.34	28.18 ± 1.23	NS
IHD	10.72	58.33	< 0.05
Diabetes	5.25	16.67	NS
Hypertension	22.98	58.33	< 0.05
COAD	11.16	37.5	< 0.05
Previous Laparotomy	16.63	37.5	< 0.05
Laparoscopic (n) Open	409 48	2 24	< 0.05
Histology Length of GB (mm)	71.25 ± 0.8777	80.96 ± 4.799	< 0.05
Histology (%) Acute cholecystitis	3.66	29.17	< 0.05