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Comment & Response
November 19, 2014

Treatment for Patients at Intermediate Risk of a Common Duct Stone

Author Affiliations
  • 1Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston
JAMA. 2014;312(19):2043. doi:10.1001/jama.2014.13419

To the Editor The randomized clinical trial (RCT) by Dr Iranmanesh and colleagues1 compared 2 commonly used clinical strategies for the evaluation of suspected choledocholithiasis in patients at intermediate risk and found that initial cholecystectomy, compared with sequential endoscopy and surgery, decreased the length of stay and number of common duct investigations. We believe that the results of this study, and their implications, should be considered in the context of 2 important caveats.

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