[Risk of surgical interventions on the gallbladder and bile ducts]

Between 1974 and 1986 2702 patients with benign disorders of the gallbladder or biliary tract have been treated operatively. The following procedures were preformed: cholecystectomy in 70.6%, choledochotomy and T-tube in 18.8%, biliodigestive anastomosis in 5.6%, transduodenal papillotomy in 3.3%, recurrent operation in 1.3%, and operation for gallstone ileus in 0.4%. 38 patients (1.4%) died within 30 days postoperatively. Mortality rates were: 0.6% for cholecystectomy, 2.6% for choledochotomy, 5.3% for biliodigestive anastomosis, 2.2% for transduodenal papillotomy, 8.8% for reoperations, and 0% for treatment of gallstone ileus. Postoperative mortality increased from 0.5% in patients younger than 50 years (0.1% for cholecystectomies) to 4.4% in patients older than 70 years (3.0% for cholecystectomies). With advancing age more complicated procedures were mandatory, while the female/male ratio declined significantly. An immediate operation for acute cholecystitis is indicated only in cases with perforated gallbladder or impending perforation.