Gallstone surgery--yesterday, today, tomorrow.
After the first cholecystectomy performed by Karl Lagenbuch in 1882 this method has become the choice for treating gallstone disease. Today mortality of this operation is less than 1%. In spite of this fact clinicians tried to find non-operative possibilities to get rid of gallstones. Litholysis performed either by oral way or percutaneous, transhepatic or retrograde, transcystic method can be used only for cholesterol stones which represent only 10% of gallstones. Intracorporeal lithotripsy by percutaneous way is an invasive method. Extracorporeal shock wave lithotripsy can be applied only for cholesterol stones of certain number, but even after careful selection of the patients only 80% become stone free in one year. All the methods which leave the gallbladder intact are not free of complications and they are followed by 50% stone recurrence in 5 years. From 1987 a new surgical procedure: laparoscopic cholecystectomy has spread all over the world. Laparoscopic surgical technique is the way to the future.
Sándor
J
J
3rd Surgical Department, Semmelweis University Medical School, Budapest.
D002763:Cholecystectomy / Q000379:methods* / Q000639:trends; D017081:Cholecystectomy, Laparoscopic / Q000379:methods* / Q000639:trends; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D005544:Forecasting; D006801:Humans; D008096:Lithotripsy / Q000379:methods* / Q000639:trends; D008297:Male