OBJECTIVE: To investigate changes in the surgical treatment of gallstones during a 10 year period. DESIGN: A retrospective study of medical records. SETTING: A community hospital serving a population of 108,000 inhabitants. SUBJECTS: All patients having their first operation for gallstones during the periods 1976-1978 and 1986-1988. RESULTS: The annual frequency of operations for gallstones decreased from 2.01 to 1.13/1,000 inhabitants, and the corresponding frequency of operations on the common duct decreased from 0.39 to 0.28. The percentage of urgent operations increased from 19 to 47. CONCLUSION: A decline in the prevalence of cholelithiasis or a more restrictive attitude of elective operations for gallstones, or both, would explain the overall reduction in surgery for gallstones. The introduction of endoscopic sphincterotomy has considerably changed the treatment of cholelithiasis. The increased age of the patients and higher percentage of urgent operations has not resulted in any increase in postoperative morbidity and mortality.
OBJECTIVE: To investigate changes in the surgical treatment of gallstones during a 10 year period. DESIGN: A retrospective study of medical records. SETTING: A community hospital serving a population of 108,000 inhabitants. SUBJECTS: All patients having their first operation for gallstones during the periods 1976-1978 and 1986-1988. RESULTS: The annual frequency of operations for gallstones decreased from 2.01 to 1.13/1,000 inhabitants, and the corresponding frequency of operations on the common duct decreased from 0.39 to 0.28. The percentage of urgent operations increased from 19 to 47. CONCLUSION: A decline in the prevalence of cholelithiasis or a more restrictive attitude of elective operations for gallstones, or both, would explain the overall reduction in surgery for gallstones. The introduction of endoscopic sphincterotomy has considerably changed the treatment of cholelithiasis. The increased age of the patients and higher percentage of urgent operations has not resulted in any increase in postoperative morbidity and mortality.