[What is the contribution of surgery in cholelithiasis today?].

1631 patients with cholelithiasis were operated on between 1984 and 1989 at the St. Clara Hospital in Basel. Mortality and rate of reinterventions were evaluated. 1357 patients had cholecystectomy with a mortality of 0.07%, 217 patients needed an exploration of the common bile duct, which increased the mortality rate to 0.9%. 57 patients had a transduodenal papillotomy, biliodigestive anastomosis or a reoperation without any death. The overall mortality was 0.18%. The mortality for patients over 60 years was 0.4%, there were no deaths for patients under 60 years. The mortality did not increase when there was an acute inflammation of the gallbladder. Reinterventions had to be done in 1.3%. The most common reason for reoperation was a retained common duct stone, which was then removed by endoscopic sphincterotomy (0.86%). Operative injury of the common duct occurred in 0.6% (1 of 1631 patients). Cholecystectomy is still standard treatment of cholelithiasis because of its low mortality and reintervention rate.