[General practice-relevant conclusions based on 74,400 documented biliary surgery interventions]

A statewide report card system for cholecystectomy as a surgical tracer has been established in Westfalia-Lippe as part of a program of external quality assurance. 74,400 data between 1993 and 1997 were analyzed. Pathologic findings in preoperative diagnostics (sonography, elevated bilirubin) do not lead to therapeutic splitting in a sufficient number of cases. Removal of bile duct stones should happen at the latest during cholecytectomy. Preoperative gastroscopy is performed in just about 40%. Higher rates of morbidity and lethality in the aged favour an early elective operation of symptomatic stones.