Effect of statin use on outcome of symptomatic cholelithiasis: a case-control study

Abstract

BackgroundStatins can modify bile cholesterol and, thus, the formation of gallstones. We examined whether statin use also modifies the severity of symptomatic gallstone disease and its treatment.MethodsA total of 1,140 consecutive patients with symptomatic gallstone disease were recruited during 2008-2010 at Kuopio university hospital, Finland. Case-control analysis matched the patients using (n = 272) or not using (n = 272) statins by age and sex. The baseline characteristics of the patients, need and type of surgical treatment, duration of operation, perioperative bleeding, postoperative complications and overall mortality rate were compared statistically between the study groups.ResultsMorbidity and subsequent polypharmacy occurred more frequently among the patients with statins compared to the patients without statins. There were no significant differences between the statin users and non-users regarding surgical treatment (open vs. laparoscopic cholecystectomy). The mean operation time for laparoscopic cholecystectomy was 10% shorter for the patients with statin use than for the patients without. In addition, there was a non-significant tendency for statin users to bleed less during laparoscopic operations than the non-users. There were no differences in other procedure-related parameters (e.g., operation urgency, conversions, choledochotomies, complications and mortality) in patients with or without statins.ConclusionsCompared to no treatment, statin treatment was associated with a shorter operation time for laparoscopy cholecystectomy. Other surgical outcome parameters were similar in patients with or without statins, although statin users had more polypharmacy and circulatory illnesses than non-users.

EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones

“…A Finnish case-control study matched 272 patients using statins with 272 patients not using statins by age and sex to investigate the influence of statin use on complicated gallstone disease at gallbladder surgery. While patients using statins did not have worse outcomes after cholecystectomy than non-users, statin treatment was associated with a shorter operation time for laparoscopic cholecystectomy [117]. So far, however, better controlled studies are required to confirm such findings, and statins cannot be proposed for the prevention of gallstones [118,119].…”