Open biliary surgery and the use of routine inpatient audit

'Morbidity profiles' offer a practicable and effective method of assessing overall surgical performance. In this study they have been used to document the results of elective and emergency open biliary surgery carried out on 246 consecutive patients over a 2-year period. The results demonstrate that such surgery for the treatment of cholelithiasis and its complications is extremely safe. There was one postoperative death (0.4%) and an in-hospital major morbidity rate of 4.6%. Minor morbidity was common, especially in the elderly and following emergency surgery. The data presented here will be of particular interest to the increasing number of surgeons advocating laparoscopic biliary surgery.