To the Editor.— This is in reference to the letter entitled "Management of Cholelithiasis" by Dr Thomas McKenzie, 1 published in the Jan 13 issue ofThe Journal. The conclusion drawn by our colleague was that the "brave surgeons should reject the tempting assurances of high technology in favor of that erstwhile staple of surgical practice—exploratory laparotomy." It was quite saddening to note that in this day and age there are surgeons out there (1) who take one example of a particular case and lose their faith in their diagnostic colleagues, (2) who do not distinguish the difference between cholelithiasis and choledocholithiasis, and (3) who do not interpret the medical communications rightly. There is no doubt that the diagnosis of gallstones can be either confirmed or rejected with an ultrasound examination alone in better than 90% of cases, and I do not have to give a list of references to