Reply to “Effect of Laparoscopic Cholecystectomy After Idiopathic Acute Pancreatitis May Be Overestimated”

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Reply:
As the corresponding author of our manuscript by Dr Räty et al,1 I would like to respond. Firstly, the whole study group (except Dr Mentula) decided to perform interim analysis after 4 years, because we wanted to analyze the safety of watchful waiting. The interim analysis clearly proved that laparoscopic cholecystectomy (LCC) was effective to reduce number of recurrences in idiopathic acute pancreatitis. For personal reasons, Dr Mentula decided to withdraw from the study. Secondly, the median follow-up was 36 (5–58) months, and 72 patients were followed up for at least 2 years. In the prospective randomized study, the randomization and outcome analysis has to be stopped at a certain time-point. Those recurrences that would happen after that time-point will be reported later (we are planning to reanalyze the recurrences after 5 years again). The NNT value of 5 means that not all recurrences are prevented by LCC (as the one case Dr Mentula referred). We need to operate 5 LCC to prevent 1 recurrence. The whole study group is sincerely acknowledged that Dr Mentula has recruited the patients into our trial. The whole study group has also approved this response letter.

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