Abstract
It can be said that the treatment for cholelithiasis except for certain cases of complicated hepatolithiasis has been accomplished. Accurate information about the lesion of the biliary system can be obtained by recently developed clinical and laboratory examinations, and it is now possible to adopt appropriate operative procedure to each individual case. It has also been confirmed in this decade that oral drug therapy is sufficient to dissolve cholesterol gallstones in some selected cases. The correct choice should be made in deciding on the method of treatment. The authors intention is therefore to consider what are good indications for surgical treatment of cholelithiasis at the present time. Based on excellent results established by biliary surgery, all cholelithiasis cases may be indicated of surgery unless the operation itself is contraindicated. An emergency surgery is absolutely necessary for acute gangrenous cholecystitis, especially when there is a risk of perforation or a perforated case, highly jaundiced patients and acute (obstructive) suppurative cholangitis. Other absolute indications are cholelithiasis of non-cholesterol stone, choledocholithiasis and/or hepatolithiasis, empyema or hydrops of the gallbladder, cases with the risk of associated carcinoma, etc.
