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Long-term risk of pancreatitis and diabetes after cholecystectomy in patients with cholelithiasis but no pancreatitis history: A 13-year follow-up study

  • Ming-Shian Tsai
    Affiliations
    Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
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  • Cheng-Li Lin
    Affiliations
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Yao-Chun Hsu
    Affiliations
    Department of Gastroenterology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
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  • Hui-Ming Lee
    Affiliations
    Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
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  • Chia-Hung Kao
    Correspondence
    Corresponding author at: Graduate Institute of Clinical Medical Science and, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der, Road, Taichung 404, Taiwan. Tel.: +886 4 22052121x7412; fax: +886 4 22336174.
    Affiliations
    Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan

    School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

    Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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      Highlights

      • Cholecystectomy was associated with a reduced risk of pancreatitis.
      • Pancreatitis risk was decreased in patients younger than 50 and older than 65 years.
      • Both men and women exhibited reduced risks of pancreatitis after cholecystectomy.

      Abstract

      Background & aim

      Patients with biliary pancreatitis are suggested to undergo cholecystectomy to prevent the recurrence of pancreatitis. However, it remains controversial whether cholecystectomy is associated with reduced risks of pancreatitis and diabetes in patients with cholelithiasis and no history of pancreatitis.

      Methods

      From Taiwan's National Health Insurance Research Database, we identified the following cohorts and analyzed the long-term risks of pancreatitis and diabetes in each cohort: 1) cholecystectomy cohort: cholelithiasis patients who had no history of pancreatitis and diabetes and underwent cholecystectomy; and 2) comparison cohort: cholelithiasis patients who had no history of pancreatitis and diabetes and did not undergo cholecystectomy.

      Results

      The cholecystectomy group and the comparison group had similar distributions of age, sex, and comorbidities, except for hyperlipidemia. The proportion of patients in the cholecystectomy group who underwent endoscopic cholangiographic procedures was higher than that in the comparison group. Cholecystectomy was associated with a reduced risk of pancreatitis (adjusted hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.36–0.68). Age-specific analyses showed that pancreatitis risk was decreased in patients younger than 50 and older than 65 years. Both men and women exhibited reduced risks of pancreatitis after cholecystectomy. However, cholecystectomy was not associated with changes in the risk for diabetes.

      Conclusion

      Cholecystectomy for cholelithiasis is associated with a reduced risk of pancreatitis, but not of diabetes, in patients without previous history of pancreatitis and diabetes.

      Abbreviations:

      HR (hazard ratio), CI (confidence interval), NHIRD (National Health Insurance Research Database), LC (laparoscopic cholecystectomy), NHI (National Health Insurance), LHID2000 (the Longitudinal Health Insurance Database 2000), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification)

      Keywords

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