Diehl and colleagues1 have contributed to our understanding of biliary pancreatitis by demonstrating that gallbladders removed from patients who had biliary pancreatitis were more likely to contain at least 1 gallstone smaller than 5 mm in diameter, which will be referred to as a small gallstone, than those from patients who had uncomplicated biliary pain (85% vs 46%, respectively). The authors concluded that watchful waiting is inappropriate when treating patients with small gallstones who have had a single attack of uncomplicated biliary pain because of a perceived unacceptable risk for future pancreatitis. I question whether their results support this conclusion.
Cohen ME. Gallstone Size and Risk for Pancreatitis. Arch Intern Med. 1998;158(5):543–544. doi:
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