Advantages of elective surgical treatment of gallstones

The author presents the mortality and morbidity of the surgical treatment of calculous disease of the biliary tract, especially cholecystectomy for chronic cholecystitis and cholelithiasis. Between 1932 and 1984, 10,749 patients underwent cholecystectomy, with an operative mortality of 0.4%. The most frequent cause of death in these patients was advanced age and cardiovascular diseases. Comparatively few patients with gallstones have been treated with bile acids alone or in combination with shock wave lithotripsy or by contact dissolution with MTBE. Although success with the non-operative techniques is improving, the high recurrence of biliary calculi imposes serious limitations on their effectiveness.