Quality assurance in surgery has a long tradition. In the last twenty years, especially externe quality assurance was very important. Pioneers of this development were Schega and Scheibe and the East German working group for quality assurance in surgery. After preparations of Scheibe in some federal countries, global measures could be started. In 1993, also in Sachsen-Anhalt we started externe quality assurance in surgery with the diagnosis gallstone disease and cholecystitis. The experiences and results of a 3-year period will be shown.