[Therapy for cholelithiasis]

It is recommended that elective cholecystectomy for cholelithiasis be performed right away after the first colic. This decreases the operative mortality to 0.3-1.0%. 2. The occurrence of local complications leads to a ten-fold increase in mortality. 3. Patients with gallstones but without symptoms should be operated during their 5th decade of life because half of these patients will later on develop serious symptoms and 25% even critical local complications requiring surgery. Operative mortality in the old age group, however, is considerably higher at 7-20%. 4. The acute cholecystitis should nowadays be treated by surgeons because early operation usually results in an operative mortality of as low as 1-1.5%. 5. The postoperative treatment of choice for residual common duct stones is either chemical dissolution via the T-tube extraction via the T-tube canal or endoscopic retrograde extraction of the stone after papillotomy. A reoperation is indicated only in the rare event that these methods should fail.