Reply to: 464-2008-283: Re: “Biochemical predictors for absence of common bile duct stones in patients undergoing laparoscopic cholecystectomy” (2008; 22(7):1620–1624)

Dear Editor

Thank you for your interest in our article. We hope that the following responses will answer your questions:

• 1. The purpose is to predict the absence of common bild duct (CBD) stones prior to laparoscopic cholecystectomy, instead of the presence of CBD stones. Therefore, all patients included in our study were presumed to have no CBD stones and obstruction before laparoscopic cholecystectomy; so, there should be no sings of CBD obstruction.

• 2. Certainly, ultrasonography was our first-choice diagnostic imaging study for simple gallstone disease, except under other special conditions such as for other abdominal conditions not completely related to gallstone.

• 3. This was a retrospective study, so we could not tell exactly why the number of computed tomography (CT) scans was high. However, CT scan is definitely not our first-choice diagnostic tool for simple gallstone disease.

• 4. Sometimes, we did test total bilirubin and alkaline phosphatase twice if they were borderline abnormal. However, that was not our routine practice.

Thank your for giving us this opportunity to reply the letter.