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Changing patterns of gallstone disease in Korea

  • Surgical Globetrotting
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Abstract

The aim of this study was to investigate the epidemiologic characteristics and changing patterns of gallstone disease in Korea over a recent 20-year period. A total of 4020 gallstone patients who had undergone surgery at Seoul National University Hospital during 1981–2000 were analyzed according to periods: period I (1981–1985: 831 cases); period II (1986–1990: 888 cases); period III (1991–1995: 1040 cases); period IV (1996–2000:1261 cases). The literature from 13 institutes in Korea reporting a total of 13,101 gallstone cases were reviewed to elucidate the nation-wide trend. The number of gallstone cases gradually increased. A female predominance was not noted (F/M = 1.17–1.37) as is seen in Western countries. The patients with common bile duct (CBD) stones were older than those with gallbladder (GB) stones or intrahepatic duct (IHD) stones. Over time, the relative proportion of those with a GB stone increased, plateauing (80–85%) during the 1990s; that of patients with CBD stones decreased (34% → 19%); and that of those with IHD stones remained unchanged (11–15%). Over the entire period, the rural pattern of gallstone formation (low number of GB stones, high numbers of CBD and IHD stones) has become similar to the urban pattern. The body mass index (BMI) of the GB stone group was above average, as were the BMIs of the CBD stone and IHD stone groups. Throughout the literature review, this same changing pattern of the relative proportion of gallstone disease was confirmed. Thus the pattern of gallstone disease in Korea has become similar to that seen in Western countries except for a high prevalence of hepatolithiasis.

Résumé

Le but de cette étude a été de déterminer les caractéristiques épidémiologiques et leurs éventuels aspects évolutifs de la maladie lithiasique en Corée pendant les 20 dernières années. On a analysé les dossiers de 4020 patients présentant une lithiase à l’Hôpital National Universitaire de Seoul (1981–2000) pendant plusieurs périodes différentes: période I 1981–1985:831 cas), période II (1986–1990:888 cas), période III (1991–1995:1040 cas) et période IV (1996–2000:1261 cas). La littérature provenant de 13 institutions en Corée rapportant 13101 cas de lithiase a été revue pour élucider la tendance nationale. Le nombre de cas de lithiase a augmenté. Comme dans les pays Occidentaux, on a noté une prédominance féminine (F/M = 1.17–137). Les patients ayant une lithiase de la voie biliaire principale (VBP) était plus âgés que les patients ayant une lithiase biliaire simple ou les patients ayant une lithiase intrahépatique (LIH). Avec le temps, la proportion relative de patients ayant une lithiase vésiculaire a augmenté pour atteindre un plateau (80–85%) dans les années 1990, la proportion de patients porteur de lithiase de la VBP a diminué (34% → 19%) et le groupe de patients porteurs de LIH est restée inchangée (11–15%). De même, le site de la lithiase (bas, haut, intrahépatique) dans la population rurale s’est rapproché de ce que l’on observe en ville. L’indexe de masse corporelle dans le groupe porteur de lithiase vésiculaire était plus élevé que la moyenne, et plus élevé que celui des patients porteur de lithiase de la VBP ou de LIH. A travers une revue de la littérature, cette même tendance s’est confirmée en ce qui concerne la proportion relative de patients porteurs de maladie lithiasique. Les tendances de la maladie lithiasique en Corée sont devenues similaires à celles des pays occidentaux sauf en ce qui concerne la prévalence élevée de lithiase intrahépatique.

Resumen

Investigar la evolución de las características epidemiológicas de la litiasis biliar a lo largo de los últimos 20 años en Corea. Se analizaron 4020 pacientes con litiasis biliar tratados quirúrgicamente en el Hospital Nacional Universitario de Seoul. Se dividieron, de acuerdo con diferentes periodos de tiempo: periodo I (1981–1985; n = 831), periodo II (1986–1990; n = 888) periodo III (1991–1995, n = 1,040) y periodo IV (1996–2000; n = 1,261). Además, se revisaron 13,101 casos de litiasis biliar de 13 Instituciones Hospitalarias de Corea, con objeto de averiguar la tendencia de esta enfermedad a escala nacional. La incidencia de la litiasis biliar se ha incrementando paulatinamente; sin embargo, no se constató una predominancia por el sexo femenino (M/V = 1.77–137) como ocurre en países occidentales. Los pacientes con coledocolitiasis (CBD) eran más viejos que los que aquejaban una colelitiasis (GB) o una hepatolitiasis (IHD). A lo largo del tiempo, los pacientes con GB aumentaron hasta alcanzar una meseta (80–85%) en los años noventa. La coledocolitiasis disminuyó (34% → 19%) y la hepatolitiasis no se modificó (11–15%). A lo largo de estos 20 años, las características de la litiasis biliar en zonas rurales (escasos casos de GB y muchos de CBD y IHD) se fue equiparando a los de las ciudades. El índice de masa corporal era superior en pacientes con GB que en los que presentaron una CBD o IHD. Nuestras observaciones coinciden con las referidas en la literatura mundial al respecto. Las características de la litiasis biliar en Corea son semejantes a las observadas en los países occidentales, excepto por lo que a la alta incidencia de hepatolitiasis (IHD) se refiere.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University, College of Medicine, 28 Yongon-dong, Chongno-gu, 110-744, Seoul, Korea

    Yong -Hyun Park, Sang -Jae Park, Jin -Young Jang, Young Joon Ann, Youn -Chan Park & Sun -Whe Kim

  2. Department of Internal Medicine, Seoul National University, College of Medicine, 28 Yongon-dong, Chongno-gu, 110-744, Seoul, Korea

    Yong Bum Yoon

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  1. Yong -Hyun Park
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Correspondence to Sun -Whe Kim.

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Park, Y.H., Park, S.J., Jang, J.Y. et al. Changing patterns of gallstone disease in Korea. World J. Surg. 28, 206–210 (2004). https://doi.org/10.1007/s00268-003-6879-x

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