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Risk of Hepato-Biliary Cancer After Cholecystectomy: a Nationwide Cohort Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Epidemiologic studies have identified cholecystectomy as a possible risk factor for cancers in Western countries. The aim of this study was to estimate the risk of hepato-biliary cancer after cholecystectomy in Taiwan.

Methods

Based on the Taiwan National Health Insurance Research Database, 2,590 cholecystectomized patients without prior cancers in the period 1996–2008 were identified from a cohort dataset of 1,000,000 randomly sampled individuals. The standard incidence ratio (SIR) of each cancer was calculated.

Results

After a median follow-up of 4.82 years, 67 liver cancer and 17 biliary tract cancer patients were diagnosed. Patients who received cholecystectomy had higher risks of liver cancer (SIR, 3.29) and biliary tract cancer (SIR, 8.50). Cholecystectomized patients aged ≤60 years had higher risks of liver cancer (SIR, 11.14) and biliary tract cancer (SIR, 55.86) compared to those aged >60 years (SIR, 2.31 and 5.67). Female cholecystectomized patients had higher risks of liver cancer (SIR, 4.18) and biliary tract cancer (SIR, 10.56) than males (SIR, 2.96 and 7.26). Cholecystectomized patients with cirrhosis had higher SIR of liver cancer than patients without cirrhosis (SIR, 33.84 vs. 1.41).

Conclusions

Cholecystectomy may be associated with an increased risk of hepato-biliary cancer. Further and regular surveillance should be performed on such patients.

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Abbreviations

DM:

Diabetes mellitus

NHIRD:

National Health Insurance Research Database

SIR:

standardized incidence ratio

CI:

confidence interval

ICD-9-CM:

International Classification of Diseases, 9th Revision, Clinical Modification

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Acknowledgments

This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by the National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or National Health Research Institutes.

Contributions

Drs. WY Kao and CY Hwang contributed equally to this work.

Disclosures

There is no potential conflict of interest involved in this paper.

Grant Support

None.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei, 112, Taiwan

    Wei-Yu Kao, Chien-Wei Su, Jiing-Chyuan Luo, Ming-Chih Hou, Han-Chieh Lin & Fa-Yauh Lee

  2. Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Chian-Yaw Hwang & Yun-Ting Chang

  3. Department of Dermatology, National Yang-Ming University, Taipei, Taiwan

    Chian-Yaw Hwang & Yun-Ting Chang

  4. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Wei-Yu Kao, Chien-Wei Su, Jiing-Chyuan Luo, Ming-Chih Hou, Han-Chieh Lin & Fa-Yauh Lee

  5. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Chien-Wei Su & Jaw-Ching Wu

  6. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

    Jaw-Ching Wu

  7. Division of Gastroenterology, Department of Medicine, Taoyuan branch, Taipei Veterans General Hospital, Taipei, Taiwan

    Wei-Yu Kao

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  1. Wei-Yu Kao
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Correspondence to Jiing-Chyuan Luo.

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Kao, WY., Hwang, CY., Su, CW. et al. Risk of Hepato-Biliary Cancer After Cholecystectomy: a Nationwide Cohort Study. J Gastrointest Surg 17, 345–351 (2013). https://doi.org/10.1007/s11605-012-2090-4

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  • DOI: https://doi.org/10.1007/s11605-012-2090-4

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