Risk of cholangiocarcinoma in patients undergoing therapeutic endoscopic retrograde cholangiopancreatography or cholecystectomy: A population based study

Wang, Chi‐Chih; Tsai, Ming‐Chang; Sung, Wen‐Wei; Yang, Tzu‐Wei; Chen, Hsuan‐Yi; Su, Chang‐Cheng; Tseng, Ming‐Hseng; Lin, Chung‐Yen

doi:10.4251/wjgo.v11.i3.238

Cited by 9 publications

(12 citation statements)

References 40 publications

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“…This study was a population-based retrospective cohort study based on Taiwan's NHIRD, which covers more than 99% of the entire population ( 30 ). The NHIRD has been described in detail in previous studies ( 31 – 33 ).…”

Section: Methodsmentioning

confidence: 99%

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

Wang

Tseng

et al. 2021

Front. Surg.

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Background: Cholecystectomy (CCY) is the only definitive therapy for acute cholecystitis. We conducted this study to evaluate which patients may not benefit from further CCY after percutaneous transhepatic gallbladder drainage (PTGBD) has been performed in acute cholecystitis patients.Methods: Acute cholecystitis patients with PTGBD treatment were selected from one million random samples from the National Health Insurance Research Database obtained between January 2004 and December 2010. Recurrent biliary events (RBEs), RBE-related medical costs, RBE-related mortality rate and an RBE-free survival curve were compared in patients who accepted CCY within 2 months and patients without CCY within 2 months after the index admission.Results: Three hundred and sixty-five acute cholecystitis patients underwent PTGBD at the index admission. A total of 190 patients underwent further CCY within 2 months after the index admission. The other 175 patients did not accept further CCY within 2 months after the index admission. RBE-free survival was significantly better in the CCY within 2 months group (60 vs. 42%, p < 0.001). The RBE-free survival of the CCY within 2 months group was similar to that of the no CCY within 2 months group in patients ≥ 80 years old and patients with a Charlson Comorbidity Index (CCI) score ≥ 9.Conclusions: We confirmed CCY after PTGBD reduced RBEs, RBE-related medical expenses, and the RBE-related mortality rate in patients with acute cholecystitis. In patients who accepted PTGBD, the RBE and survival benefits of subsequent CCY within 2 months became insignificant in patients ≥ 80 years old or with a CCI score ≥ 9.

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Section: Methodsmentioning

confidence: 99%

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

Wang

Tseng

et al. 2021

Front. Surg.

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“…This study was a population-based retrospective cohort study based on Taiwan's NHIRD, which covers more than 99% of the entire population [30] . The NHIRD has been described in detail in previous studies [31][32][33].…”

Section: Methodsmentioning

confidence: 99%

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

Wang¹,

Wu²,

Yang³

et al. 2020

SSRN Journal

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Background Cholecystectomy (CCY) is the only definitive therapy for acute cholecystitis. We conducted this study to evaluate which patients may not benefit from further CCY after percutaneous transhepatic gallbladder drainage (PTGBD) has been performed in acute cholecystitis patients. Methods Acute cholecystitis patients with PTGBD treatment were selected from one million random samples from the National Health Insurance Research Database obtained between January 2004 and December 2010. Recurrent biliary events (RBEs), RBE-related medical costs, RBE-related mortality rate and an RBE-free survival curve were compared in patients who accepted CCY within 2 months and patients without CCY within 2 months after the index admission. Results 365 acute cholecystitis patients underwent PTGBD at the index admission. A total of 190 patients underwent further CCY within 2 months after the index admission. The other 175 patients did not accept further CCY within 2 months after the index admission. RBE-free survival was significantly better in the CCY within 2 months group (60% vs. 42%, p<0.001). The RBE-free survival of the CCY within 2 months group was similar to that of the no CCY within 2 months group in patients ≥ 80 years old and patients with a Charlson Comorbidity Index (CCI) score ≥ 9. Conclusion We confirmed CCY after PTGBD reduced RBEs, RBE-related medical expenses, and the RBE-related mortality rate in patients with acute cholecystitis. In patients who accepted PTGBD, the RBE and survival benefits of CCY within 2 months became insignificant in patients ≥ 80 years old or with a CCI score ≥ 9. Background: Cholelithiasis is one of the most popular diseases with increasing prevalence and substantial burden on healthcare resources [1, 2]. Because the abundant access to food worldwide increases the risk of obesity, the incidence rates of cholelithiasis grow accordingly [3, 4]. Cholecystitis refers to inflammation of the gallbladder, and it can be defined as acute or chronic cholecystitis by the duration of the disease. Acute acalculous cholecystitis accounts for only less than 10%[5, 6] of all cholecystitis patients. Acute cholecystitis is a complication of gallstone disease and typically develops in patients with a history of symptomatic gallstones[7, 8].

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“…This study was a population-based retrospective cohort study based on Taiwan’s NHIRD 2004-2011, and the study methods of the NHIRD have been described in detail in previous studies[ 3 , 35 - 37 ]. This study was approved by the Institutional Review Board (IRB) of Chung Shan Medical University Hospital, Taiwan.…”

Section: Methodsmentioning

confidence: 99%

“…Cholangiocarcinoma, which carries a medium incidence and high mortality rate[ 1 ], has been under re-evaluation in Asia-Pacific countries[ 2 , 3 ]. Over the past two decades, the incidence of intra-hepatic cholangiocarcinoma (ICC) has increased, while the incidence of extra-hepatic cholangiocarcinoma has declined internationally[ 4 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have shown differing results regarding cholecystectomy (CCY) due to cholelithiasis and subsequent ICC[ 32 ] or extra-hepatic cholangio-carcinoma[ 33 , 34 ], our prior study revealed that cholelithiasis patients who undergo endoscopic sphincterotomy/endoscopic papillary balloon dilatation (ES/EPBD) are at a greater risk for subsequent cholangiocarcinoma, while cholelithiasis patients who undergo CCY have reduced risk for subsequent cholangiocarcinoma[ 3 ]. These results can be explained by different inflammation sites or by CCY reducing recurrent biliary events (RBEs)[ 35 ] and further decreasing future cholangiocarcinoma rates.…”

Section: Introductionmentioning

confidence: 99%

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Cholecystectomy reduces subsequent cholangiocarcinoma risk in choledocholithiasis patients undergoing endoscopic intervention

Wang¹,

Tseng²,

Wu³

et al. 2020

WJGO

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BACKGROUND Cholangiocarcinoma is a disease with a high mortality rate. Our previous study revealed that cholelithiasis patients who undergo endoscopic sphincterotomy (ES)/endoscopic papillary balloon dilatation are at a higher risk for subsequent cholangiocarcinoma than cholelithiasis patients who undergo cholecystectomy. AIM To clarify the relationship between recurrent biliary events and subsequent cholangiocarcinoma risk in choledocholithiasis patients. METHODS From one million random cases in the Taiwan National Health Insurance Research Database 2004–2011, we selected symptomatic choledocholithiasis patients older than 18 years who were admitted from January 2005 to December 2009 (study group). Cases for a control group were defined as individuals who had never been diagnosed with cholelithiasis, matched by sex and age in a 1:3 ratio. The study group was further divided into ES/endoscopic papillary balloon dilatation, both ES/endoscopic papillary balloon dilatation and cholecystectomy, and no intervention groups. RESULTS We included 2096 choledocholithiasis patients without previous intervention or cholangiocarcinoma. A total of 12 (2.35%), 11 (0.74%), and 1 (1.00%) subsequent cholangiocarcinoma cases were diagnosed among 511 ES/endoscopic papillary balloon dilatation patients, 1485 patients with no intervention, and 100 ES/endoscopic papillary balloon dilatation and cholecystectomy patients, respectively. The incidence rates of recurrent biliary event were 527.79/1000 person-years and 286.69/1000 person-years in the subsequent cholangiocarcinoma and no cholangiocarcinoma group, showing a high correlation between subsequent cholangiocarcinoma risk and recurrent biliary events. CONCLUSION Choledocholithiasis patients who undergo further cholecystectomy after ES/endoscopic papillary balloon dilatation have decreased subsequent cholangiocarcinoma risk due to reduced recurrent biliary events.

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Risk of cholangiocarcinoma in patients undergoing therapeutic endoscopic retrograde cholangiopancreatography or cholecystectomy: A population based study

Cited by 9 publications

References 40 publications

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

Cholecystectomy reduces subsequent cholangiocarcinoma risk in choledocholithiasis patients undergoing endoscopic intervention

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