[Abstract Not Included]


The results of biliary tract surgery in three small general hospitals serving suburban communities was studied. Their average daily censuses were 38, 70, and 97. Fourteen (4.5%) of 310 cases of benign biliary tract disease died after surgery. Among 219 cases of elective cholecystectomy, four patients (l.8%) died. The mortality in 1196 cases reported from small hospitals by this, and three other authors, was 3.3%. This is slightly higher than the mean mortality, 2.4% among 25 reports of surgical mortality for gall stone disease found in the literature. The maximum number of cases came to surgery during the 6th decade. The highest relative incidence of elective biliary tract surgery was also during the 6th decade. The highest relative incidence of elective biliary tract surgery was also during the 6th decade. However, the relative incidence of urgent surgery for acute cholecystitis continued to rise beyond the 70th year. One-fifth of the operations were for acute cholecystitis. The mortality in surgically-treated acute cholecystitis was four times greater than in elective surgery for gall stone disease. One-fifth of the patients were males. Half the fatalities were among males. Bile duets were opened in less than 10% of all cases. Stones were found in a little over half of those which were opened. The remarkable rise in surgical mortality rate with advancing age is analyzed and graphically emphasized. The term "hazard index" is suggested to designate the quantity of life which is risked. This may be a significant consideration in advising prophylactic surgery. It is believed that great variation from one to another of the smaller community hospitals will be found. The higher mortality found in some of the smaller hospitals suggests that scrutiny of their work by each individual hospital staff may yield noticeable improvement of policy and procedure, ultimately reflected in better results.


Graduate School

Degree Name

Master of Science in Medical Sciences (MSMS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Cholecystectomy; Biliary Tract Diseases



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Digital Format


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Loma Linda University Libraries

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This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


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