DAVID HOCH, M.D.; BETH SCHORR-LESNICK, M.D.; PAUL MARANTZ, M.D., M.P.H.
To the editor: Ransohoff and colleagues (1) have provided an interesting reexamination of the clinical dogma that surgery should be considered for diabetic patients with asymptomatic gallstones. There is, however, a methodologic problem we feel should be addressed before this approach is abandoned.
To arrive at the final sample of 311 patients, 1978 charts were reviewed. Among the exclusion criteria was acute pancreatitis, accounting for 87 patients. No rationale was given for this exclusion, and if there is a relation between development of pancreatitis and diabetes, this could lead to significant confounding.
The importance of this factor can be examined
HOCH D, SCHORR-LESNICK B, MARANTZ P. Asymptomatic Gallstones in Diabetic Persons. Ann Intern Med. ;107:942. doi: 10.7326/0003-4819-107-6-942_1
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Published: Ann Intern Med. 1987;107(6):942.
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