Chi-Tung Cheng1,2, Chun-Nan Yeh3, Kun-Chun Chiang4,5, Ta-Sen Yeh6, Kuan-Fu Chen7,8,9, Shao-Wei Chen10,11. 1. Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 2. Institute of Biomedical Informatics, National Yang-Ming University, Taipei, 11221, Taiwan. 3. Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, University, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan. yehchunnan@gmail.com. 4. Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan. 5. Chang Gung University, Taoyuan, Taiwan. 6. Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, University, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan. 7. Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan. 8. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan. 9. Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan. 10. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 11. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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.
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.
Entities:
Keywords:
Cholecystectomy; Common bile duct stone; Endoscopic retrograde cholangiopancreatogram; Recurrence
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