[Results of biliary surgery in a teaching center]

The last few years have seen the introduction of new medical approaches to treatment of gallstone disease. To investigate whether this was the consequence of disappointing results following surgical treatment, we undertook a one-year prospective study at the Clinic of Digestive Surgery in Geneva, a training center with an unselected patient population. From October 1986 to September 1987, 306 biliary operations were performed for calculous disease by 20 surgeons, most of whom were under training. Juniors were supervised by senior surgeons. Operative indications and management were based on the strict criteria established at our center. Over half the patients had suffered one or more complications of gallstone disease. Overall mortality and morbidity were 0.3% and 11.7% respectively. In conclusion, gallstone surgery, which is a definitive treatment, has provided us with very acceptable results and therefore should not be a reason for encouraging other conservative approaches in the treatment of gallstone disease.