[The surgeon's role in the treatment of cholelithiasis]

From a surgeon's point of view, the management of biliary tract calculi can be simplified as follows: 1) In the asymptomatic patients a prophylactic surgery is not justified. 2) In the symptomatic patients the cholecystectomy is by far the best procedure as it eliminates the symptoms and it prevents the complications. 3) If performed in elective and good-risk patients, this surgical technique is without morbidity and mortality. 4) Such a statement which absolutely fits in case of laparotomic cholecystectomy, is not true in case of laparoscopic cholecystectomy which, on the contrary, presents with an higher mortality. 5) Laparoscopic cholecystectomy must be performed by surgeons with biliary tract management wide experience. 6) The management of complications is still almost surgical. 7) Common duct calculi are often treated by endoscopic techniques in association with surgery. 8) The surgeon must always be able to evaluate his patient and to suggest the best management with particular regard to the alternative not surgical procedures which sometimes are more favourable to the patient. 9) Actually, to left behind the statement "a chance to cut is a chance to cure" could sometimes involve much credit to the surgeon and more profit to the patient.