We thank Dimitrios Moris and Theodore Pappas for their comments and suggestions to further optimise the selection criteria for laparoscopic cholecystectomy in patients with abdominal pain and gallstones. We accept the concerns about the protocol violations. The SECURE trial1 was designed to better select patients for cholecystectomy, but it stops short of answering the question of how to treat patients with abdominal symptoms and gallstones.
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