[Cholelithiasis--indications for cholecystectomy, papillotomy and gallstone dissolution (author's transl)].

Patients under 50 years without risk factors carrying gallstones should be operated upon for the following reasons: (1) These patients will have complications in up to 40% of cases with increasing age; (2) only 18% of patients are without complaints after a duration of this disease of twenty years; (3) mortality of surgery is 1,06% in patients with no other risk factors. Patients at risk for other reasons, with a functional gallbladder and carrying calcium-free stones should be treated with chenodesoxycholic acid. Patients at risk for other reasons carrying residual stones after cholecystectomy, or suffering from stenosis of the papilla, or harboring stones in the choledochus after choledochoduodenostomy should be subjected to endoscopic papillotomy. Patients at risk for other reasons suffering from cholecystolithiasis or choledocholithiasis should be subjected at first to endoscopic papillotomy, and only thereafter to cholecystectomy. This will decrease the risk of surgery.