New trends in the treatment of calculus disease of the biliary tract.

BACKGROUND New treatment methods for calculus disease of the biliary tract offer options that can benefit a variety of patients. Laparoscopic surgery, for example, has revolutionized biliary surgery and is now the preferred approach for the majority of patients. METHODS Using the key words "biliary tract," "calculus disease," and "cholecystectomy," MEDLINE files were searched from 1982 to the present. Articles dating before 1982 were accessed from the reference lists of the more recent articles. RESULTS AND CONCLUSIONS This review describes the various procedures that could be effective options for patients with biliary stone disease, including an algorithm showing a proposed scheme for evaluating and treating this disease. Cholecystectomy--either laparoscopic or open--will likely remain the treatment of choice for most patients. The newer options, however, for treatment of both acute and chronic cholecystitis have proved effective in select cases.