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Recurrence of gallstones after cholecystectomy is associated with ABCG5/8 genotype

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Gallstone disease is a frequent and economically highly relevant disorder, with cholecystectomy representing one of the most frequently performed operations world-wide. Gallstone recurrence after cholecystectomy is associated with complications such as biliary sepsis and pancreatitis. As yet, variant ABCG8-D19H is the most widely recognized genetic risk factor for gallstone disease. The aim of the study is to investigate whether ABCG8-D19H is associated with gallstone recurrence after cholecystectomy.

Methods

Two thousand three hundred and eight patients from an earlier study of gallstone risk factors were re-contacted by mail, leading to 1,915 patients with available clinical and genetic information. Symptomatic gallstone recurrence was established if it occurred more than six months after surgery. Median follow-up time after cholecystectomy was eight years.

Results

Gallstones recurred in 37 patients (1.9 %). ABCG-D19H was found to be significantly associated with gallstone recurrence (p = 0.034). The allelic odds ratio was 1.97 (95 % CI 1.12–∞). In a multivariate logistic regression analysis adjusted for age, sex, BMI and type of surgery, ABCG8-D19H remained a significant predictor, both in the total cohort (p = 0.024) and in the subgroup for whom information on type and scheduling of surgery was available (N = 1,650, p = 0.020).

Conclusions

ABCG8-D19H is a predictor of gallstone recurrence, a major long term postoperative biliary complication. Moreover, the observed association also reemphasizes the importance of the sterolin transporter for stone formation.

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Acknowledgments

This study was supported by the German Research Council (DFG Ha 3061/3-1), the German Ministry for Research and Education and the State of Schleswig-Holstein (both through the POPGEN biobank).

Conflict of interest

There are no competing interests.

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Authors and Affiliations

  1. Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 6, 24105, Kiel, Germany

    Witigo von Schönfels, Heiko Aselmann, Jan H. Egberts, Thomas Becker & Clemens Schafmayer

  2. Department of Internal Medicine I, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany

    Stephan Buch, Maren Wölk, Stefan Schreiber & Jochen Hampe

  3. POPGEN Biobank, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany

    Stefan Schreiber & Michael Krawczak

  4. Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany

    Michael Krawczak

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  1. Witigo von Schönfels
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  2. Stephan Buch
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  8. Thomas Becker
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  10. Clemens Schafmayer
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Correspondence to Clemens Schafmayer.

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von Schönfels, W., Buch, S., Wölk, M. et al. Recurrence of gallstones after cholecystectomy is associated with ABCG5/8 genotype. J Gastroenterol 48, 391–396 (2013). https://doi.org/10.1007/s00535-012-0639-3

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  • DOI: https://doi.org/10.1007/s00535-012-0639-3

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