Gallstones are a common disease worldwide
.
In the natural population of our country, the incidence of gallstones is about 10%
.
Female patients are more common, especially obese women, the ratio of male to female is about 1:2
.
Gallstones are one of the pathogenic factors of bile duct (gallbladder) cancer
.
According to reports, gallstones are positively correlated with liver and gallbladder cancer
.
However, the risk of these cancers in patients with cholecystectomy or complex gallstones is controversial
.
This study aims to explore the impact of cholecystectomy on the risk of cholangiocarcinoma (CCA) or hepatocellular carcinoma (HCC) in patients with gallstones and complex gallstone subgroups
.
.
In the natural population of our country, the incidence of gallstones is about 10%
.
Female patients are more common, especially obese women, the ratio of male to female is about 1:2
.
The researchers used the Korean National Health Insurance database to include gallstone patients (n=958,677) and age- and gender-matched control patients (n=9,586,770)
.
Complex gallstones are defined as gallstones associated with acute cholecystitis or acute cholangitis
.
Compared with the control group, the researchers evaluated the risk ratio (aHR, 95% CI) of the incidence of CCA and HCC in patients with gallstones undergoing cholecystectomy, and also analyzed the impact of these on patients with complex gallstones
.
The results of the study showed that compared with the control group, the risk of CCA (1.
80, 1.
67-1.
93) and HCC (1.
03, 1.
00-1.
07) in patients with gallstones was significantly increased
.
Compared with patients who did not undergo cholecystectomy, cholecystectomy had the least impact on the risk of CCA (1.
94, 1.
76-2.
14) and HCC (0.
93, 0.
87-0.
99)
.
However, the risk of CCA in patients with complex gallstones is significantly increased (5.
62, 4.
89-6.
46), and the risk after cholecystectomy is reduced by 30% (3.
91, 3.
43-4.
46)
.
Compared with intrahepatic CCA or Vater's ampullary carcinoma, cholecystectomy has a greater reduction in the risk of extrahepatic CCA
.
However, compared with the control group, there was no difference in the risk of HCC between patients with complex gallstones and those who underwent cholecystectomy
.
Finally, the researchers said: patients with complex gallstones have a significantly increased risk of CCA.
Cholecystectomy can partially reduce the risk of CCA, but the HCC risk of gallstones or cholecystectomy has little change
.
Cholecystectomy can partially reduce the risk of CCA, but the HCC risk of gallstones or cholecystectomy has little change
.
Original source:
Hyeong Sik Ahn.
Et al.
Cholecystectomy reduces the risk of cholangiocarcinoma in patients with complicated gallstones, but has negligible effect on hepatocellular carcinoma.
Journal of Gastroenterology and Hepatology.
2021.
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