[The current risk of gallbladder and bile duct surgery]

The lethal operative risk in gallbladder and bile duct operations decreased from 2.16% in the period 1964-1976 to 1.32% in the period 1979-1987.--Main operative risk factors are gallbladder and bile duct complications and the age beyond the 6th decade of life.--The lethality of choledocholithiasis actually amounts to the 37-fold of uncomplicated cholecystolithiasis and the lethality of all primary and secondary gallstone operations after the 6th decade of life amounts to the 38-fold in comparison with younger patients.--A further reduction of operative risk appears possible by reason: 1. Consequent early operation. 2. immediate operative or endoscopic removal of extrahepatic cholestasis, 3. complex intraoperative diagnostics of bile duct and papilla Vateri, 4. preoperative single dose AB prophylaxis or short-term therapy, 5. general low dose heparin prophylaxis, 6. primary endoscopic therapy in residual stones or irreversible stenosis of papilla Vateri and 7. interdisciplinary diagnosis and treatment of senile complications.