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Effects of cholecystectomy on recurrent biliary complications after endoscopic treatment of common bile duct stone: a population-based cohort study

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Abstract

Background

The aim of this study was to evaluate the benefits of cholecystectomy on mitigating recurrent biliary complications following endoscopic treatment of common bile duct stone.

Methods

We used the data from the Taiwan National Health Insurance Research Database to conduct a population-based cohort study. Among 925 patients who received endoscopic treatment for choledocholithiasis at the first admission from 2005 to 2012, 422 received subsequent cholecystectomy and 503 had gallbladder (GB) left in situ. After propensity score matching with 1:1 ratio, the cumulative incidence of recurrent biliary complication and overall survival was analyzed with Cox’s proportional hazards model. The primary endpoint of this study is recurrent biliary complications, which require intervention.

Results

After matching, 378 pairs of patients were identified with a median follow-up time of 53 (1–108) months. The recurrent rate of biliary complications was 8.20% in the cholecystectomy group and 24.87% in the GB in situ group (p < 0.001). In the multivariate Cox regression analysis, the only independent risk factor for recurrent biliary complications was GB left in situ (hazard ratio [HR] 3.55, 95% CI 2.36–5.33).

Conclusions

Cholecystectomy after endoscopic treatment of common bile duct stone reduced the prevalence of recurrent biliary complications.

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Author information

Authors and Affiliations

  1. Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Chi-Tung Cheng

  2. Institute of Biomedical Informatics, National Yang-Ming University, Taipei, 11221, Taiwan

    Chi-Tung Cheng

  3. Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, University, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan

    Chun-Nan Yeh & Ta-Sen Yeh

  4. Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan

    Kun-Chun Chiang

  5. Chang Gung University, Taoyuan, Taiwan

    Kun-Chun Chiang

  6. Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan

    Kuan-Fu Chen

  7. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan

    Kuan-Fu Chen

  8. Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan

    Kuan-Fu Chen

  9. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Shao-Wei Chen

  10. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Shao-Wei Chen

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  1. Chi-Tung Cheng
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Correspondence to Chun-Nan Yeh.

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Disclosures

Chi-Tung Cheng, Chun-Nan Yeh, Kun-Chun Chiang, Ta-Sen Yeh, Kuan-Fu Chen, Shao-Wei Chen have no conflicts of interest or financial ties to disclose.

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Cheng, CT., Yeh, CN., Chiang, KC. et al. Effects of cholecystectomy on recurrent biliary complications after endoscopic treatment of common bile duct stone: a population-based cohort study. Surg Endosc 32, 1793–1801 (2018). https://doi.org/10.1007/s00464-017-5863-8

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  • DOI: https://doi.org/10.1007/s00464-017-5863-8

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