In Reply: We agree with Drs Hsu and Kao and Dr Fujita that only a minority of patients harboring gallstones actually need cholecystectomy due to pain or due to a complication of gallstone disease, such as acute cholecystitis or pancreatitis. However, gallstone disease is frequent, with an estimated prevalence of 10% to 20% in white adults.1 Therefore, symptomatic gallstone disease (with an estimated annual incidence of cholecystitis of 0.3%2) is associated with substantial morbidity and even mortality. We agree with Hsu and Kao that our findings should not be extrapolated to patients with asymptomatic gallstones because we only included patients with symptomatic gallstones. Given the case-control design, we cannot compare cholecystectomy incidence among patients with gallstones in statin users vs nonusers.
Bodmer M, Brauchli YB, Meier CR. Use of Statins and Gallstone Risk—Reply. JAMA. 2010;303(12):1146-1147. doi:10.1001/jama.2010.322