[Gallstone surgery today]

The gold standard in treatment of cholelithiasis is and remains cholecystectomy. The gallbladder must be removed not because it contains stones but because it produces them. Only cholecystectomy prevents late complications. Laparoscopic cholecystectomy offers more comfort to the patient. By improved technique and refined instruments its indication can be continuously enlarged. Complicated forms of cholelithiasis such as the Mirizzi syndrome, chronic fibrosing cholecystitis, necrotizing infections and tumors as well as high operative risks are treated better by open cholecystectomy. Open and laparoscopic operations have both advantages and disadvantages. They are not competing procedures. On one hand, they have to be used individually according to their corresponding pathomorphology; on the other hand, their respective use has to be met by appropriate surgical skill. By no means the indication may orient itself on questions of prestige.