All “Silent” Gallstones Are Not Silent

Abstract

To the Editor: Gracie and Ransohoff¹ have suggested that in white males silent gallstones can safely be left alone, without prophylactic cholecystectomy, unless or until the patient has clinical symptoms, which were not frequent in their study. This may not apply equally to other populations and ethnic groups. In American Indians and other peoples related to them, especially in women, gallstones form early in adult life, and approach 90 per cent in prevalence if cholecystography is used to detect them² Gallstone disease is also common in Mexican-Americans, a European-American Indian admixed population, in which the prevalence of symptomatic gallstones in . . .