Familial Prevalence of Gallstones in First-Degree Relatives of Patients With Gallstones to subject their asymptomatic patients with gallstones Reply: to unnecessary surgery. Where have we made even the slightest hint that the relatives with asymptomatic We were a bit surprised to read the letter by Drs. gallstones should be subjected to surgery? Where is the Romero and Phillips. 1 It is apparent that they read our fright or the question of postcholecystectomy complicaarticle in the July issue of HEPATOLOGY 2 very casually tions? In fact, we would caution readers not to suggest and have failed to understand the clear messages of a such a course. carefully designed study. They have not provided any 5. We are happy that in the end Drs. Romero and new thoughts on the subject and their concerns seem Phillips do accept our hypothesis of high familial occurill founded. We would like to bring the following facts rence of gallstones. We are sure that after we have to their attention:
clarified their misinterpretation of certain words in our 1. The statement ''willing to participate in the study'' article, they would appreciate the scientific merits of is just another way of writing that an informed consent this carefully designed and meticulously conducted was obtained from every subject. It should not for once study. be understood to convey that ''any'' unwilling relative
The hypothesis and the results of our study are quite was excluded from the study. All relatives were inclear and cannot be refuted on emotional grounds by cluded. There is no bias.
anyone. Science develops by carefully designed studies 2. ''Which first degree relative.'' This has been amply that provide reproducible observations. Our study has detailed in the article that parents/siblings/offspring of ample support from the literature. A high familial prevthe index patient were included. There was no selection alence of gallstones has been supported by several process. Our endeavor was to include every living relaother investigators in the past. [3][4][5][6][7][8] tive, with a minimum of three per index patient (330 relatives of 105 index patients were studied). With the SHIV K. SARIN inclusion of at least 3 relatives, we aimed to screen at Department of Gastroenterology least 2 generations; parents and siblings or siblings G. B. Pant Hospital and offspring (if above the age of 15 years). None of the New Delhi, India living relatives were excluded. It is absolutely wrong