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Comment & Response
November 19, 2014

Treatment for Patients at Intermediate Risk of a Common Duct Stone—Reply

Author Affiliations
  • 1Division of Digestive and Transplant Surgery, Geneva University Hospital, Geneva, Switzerland
  • 2Division of Gastroenterology and Hepatology, Geneva University Hospital, Geneva, Switzerland
JAMA. 2014;312(19):2043-2044. doi:10.1001/jama.2014.13425

In Reply Dr Elmunzer and colleagues question whether the hospital length of stay advantage observed in the cholecystectomy-first group may reflect processes specific to the study institution or the unblinded nature of the trial. We acknowledge that initial EUS was delivered with an overall median delay of a half day compared with initial cholecystectomy. However, the difference did not approach statistical significance (median, 1 [interquartile range {IQR}, 1-2] days vs 1.5 [IQR, 1-2.75] days; P = .44). In addition, the observed overall difference in length of stay was not a result of this delay because the difference in length of stay was maintained when calculating from the initial cholecystectomy or EUS until the discharge date (median, 3 [IQR, 3-9] days vs 5 [IQR, 2-4] days; P < .001).

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