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Invited Critique
April 2010

Posing Lesser Risks Against Those That Are Greater: Comment on “Risk Factors for Acute Cholecystitis and a Complicated Clinical Course in Patients With Symptomatic Cholelithiasis”

Author Affiliations

Author Affiliation: Center for Liver Disease and Transplantation, Cedars-Sinai Medical Center, Los Angeles, California.

Arch Surg. 2010;145(4):333. doi:10.1001/archsurg.2010.38

In their article, Cho et al attempt to define the clinical factors that represent risks for the development of AC among patients with symptomatic cholelithiasis. They correctly point out that cholecystectomy in the acute setting is not only more technically challenging but is also associated with a higher incidence of common bile duct injury and postoperative morbidity in general. The authors postulate that if such risks could be identified in advance, then timely intervention with cholecystectomy could circumvent a complicated clinical course. One certainly can only agree with these commendable goals and find the number of patients studied to be impressive. Nevertheless, there may be minor conceptual or procedural issues that somewhat weaken the authors' conclusions.

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