[Cholecystectomy--the gold standard of therapy]

Elective CCE is still the treatment of choice for more than 80% of patients with gallstone disease. Surgery is indicated for biliary symptoms along with sonographic or radiographic evidence of gallstones and/or pathology of the gallbladder wall. Non-operative procedures are limited to patients with open cystic duct, preserved contractivity of the gallbladder and non-calcified stones. Mortality of elective cholecystectomy in patients less than 70 years today is 0. Emergency cholecystectomy and old age (greater than 70) are the only mortality risk factors amounting up to 4%. Recurrent surgery is necessary in less than 1% of the patients, conservatively treated postoperative morbidity less than 5%. Cholecystectomy still remains the only method, by which immediate stone release is achieved and long term medication avoided.