The results of a survey on the technique of cholecystectomy in The Netherlands indicates that evolution has taken place towards perfecting and simplifying the operating technique. Use of intraoperative diagnostic procedures, such as cholangiography, has been almost abandoned. More attention is paid to reducing operation trauma and improving cosmetic results by using intracutaneous or continuous skin sutures, and smaller access incisions. Recently extracorporeal shock wave lithotripsy and laparoscopic cholecystectomy have been introduced. In the light of our experience with extracorporeal shock wave lithotripsy and with laparoscopic cholecystectomy, these two therapeutic alternatives are discussed.

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