Relevant conclusions of 74 400 operations for biliary surgery

A statewide report card system for cholecystectomy as a surgical tracer has been established in Westphalia-Lippe as part of a program of external qual ity assurance. 74 400 data between 1993 and 1997 were analyzed. Pathologic findings in preoperative diagnostics (sonography, elevated bilirubin) do no t lead to therapeutic splitting in a sufficient number of cases. Removal of bile duct stones should happen at the latest during cholecytectomy. Preope rative gastroscopy is performed in just about 40 %. Higher rates of morbidi ty and lethality in the aged favour an early elective operation of symptoma tic stones.