[Analysis of causes of death following surgery for gallstones]

From January 1956 to December 1985, 1316 cases of gallstones were operated in our hospital. Among them, gallbladder stones accounted for 43.2%, common dile duct stones 34.6% and intrahepatic stones 22.2%. Hospital deaths occurred in 59 cases, with a mortality rate of 4.5%, and this was obviously decreased to 2.4% in the last decade. Operative risk factors included: high-age with major organ diseases; acute biliary infections, especially acute obstructive suppurative cholangitis (AOSC); reoperations etc. Control of these factors is the key to reducing the motality rate. Mortality due to cholecystectomy has dropped considerably in recent years. The main causes of death after operations for common bile duct stones is septic shock due to AOSC. Thus, early diagnosis and surgical treatment of common bile duct stones are very important in reducing the incidence of acute biliary infection and AOSC. If these occur, biliary drainage should be done as soon as possible. The main causes of death after operations for intrahepatic stones were stubborn biliary infection due to residual stones or biliary stenosis and hepatic failure due to biliary cirrhosis. It must be emphasized that the treatment of intrahepatic stones should be early and complete. Operative procedures should be determined according to individual conditions.