Abstract

A brief review of the history of mortality in biliary tract surgery indicates that there has been a marked lowering of operative risk during very recent years. Given an experienced surgeon with adequate facilities the danger of elective cholecystectomy in the able bodied patient today is certainly very slight. However, the same advances which have made possible the very Ion-mortality in elective cholecystectomy have also resulted in a greatly lessened risk in obligatory cholecystectomy and in operations for all gallstone complications. For this very reason the hazard in elective cholecystectomy must of necessity be very slight in order to justify operation in cases in which the stones are nonsymptomatic.It does appear that under circumstances permitting cholecystectomy with very slight risk, operations for silent stones are fully warranted at the discretion of the surgeon. If such a course is taken, however, the surgeon must fulfill his serious obligations with the realization that in every surgical operation at least a minimum risk to life is present.Cholecystectomy for silent stone does not result in any relief of present symptoms. In this circumstance ordinary wisdom dictates that the surgeon explain the operation to the patient so that the patient knows that the operation is being done solely for insurance against future trouble. Otherwise the patient will almost surely expect some improvement which does not follow.