[40 years biliary surgery at the surgical clinic of the Charité].

Evaluation of 4,374 bile operations performed between 1945 and 1984 revealed drop in lethality from 4.0 to 0.8 per cent. The average age distribution of patients who had undergone surgery from 1945 to 1954 was identical with that for the period between 1975 and 1984. Case histories were probably shortened owing to earlier diagnosis. The rate of choledochotomy dropped from 11.5 per cent (1945 to 1954) to 7.9 per cent (1975 to 1984). The rates of choledochotomy and surgical papillotomy declined, ever since endoscopic papillotomy had been introduced more than ten years ago. Endoscopic lithotripsy and shock-wave lithotripsy are new approaches to cholelithotherapy.