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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

The study was designed to determine whether there was an increased likelihood of finding small gallstones in patients who had pancreatitis, not the converse. Therefore, the conclusion that patients with small gallstones are at increased risk of developing pancreatitis was an informed assumption. Among the 132 subjects with small gallstones . . . [Full Text of this Article]