Surgical endoscopy · 2026
Concomitant cholecystectomy did not significantly reduce the risk of subsequent biliary events and malignancy in treating gallstone ileus.
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Su Yi-Shan, Liu Han-Yu, Chen Chung-Yen, Chi Po-Jui, Chen Jian-Han
Аннотация
BACKGROUND: This nationwide cohort study compared long-term subsequent benign biliary events and biliary tract malignancy in patients with gallstone ileus treated with or without concomitant cholecystectomy.
METHODS: This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. All patients diagnosed with gallstone ileus between 2000 and 2012 were included. Patients with a history of cholecystectomy, those of undetermined sex, and those aged < 18 years were excluded. The patients were divided into two groups based on whether they underwent concomitant cholecystectomy at the index admission. Cholecystectomy was defined using ICD-9-OP codes. The primary endpoint was re-hospitalization with a diagnosis of biliary complications and malignancy of the biliary tree. All patients were followed up until the end of 2013 for biliary complications or death.
RESULTS: We included 376 patients with a median follow-up of 34.23 months (0.07-169.7 months). There were no between-group differences in prior biliary events (p = 0.068) or in incident biliary events during follow-up (median time to event, 10.67 months from index admission; p = 0.056). The NC group had a notably higher proportion of patients with histories of congestive heart failure, cerebrovascular disease, peptic ulcers, malignancy, hypertension, and hyperlipidemia. The NC group had similar 30-day mortality but a significantly shorter hospital stay and lower overall cost than the CC group, and a higher proportion but not statistically significant (p = 0.056) of overall biliary complications. A history of biliary complications was a risk factor for biliary complications. Concomitant cholecystectomy did not significantly prevent biliary complications, including benign biliary events or malignancy.
CONCLUSION: Receiving concomitant cholecystectomy provided minimal benefit in reducing the long-term risk of biliary complications or malignancy. Therefore, the benefits of concomitant cholecystectomy during gallstone ileus treatment should be carefully evaluated.
METHODS: This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. All patients diagnosed with gallstone ileus between 2000 and 2012 were included. Patients with a history of cholecystectomy, those of undetermined sex, and those aged < 18 years were excluded. The patients were divided into two groups based on whether they underwent concomitant cholecystectomy at the index admission. Cholecystectomy was defined using ICD-9-OP codes. The primary endpoint was re-hospitalization with a diagnosis of biliary complications and malignancy of the biliary tree. All patients were followed up until the end of 2013 for biliary complications or death.
RESULTS: We included 376 patients with a median follow-up of 34.23 months (0.07-169.7 months). There were no between-group differences in prior biliary events (p = 0.068) or in incident biliary events during follow-up (median time to event, 10.67 months from index admission; p = 0.056). The NC group had a notably higher proportion of patients with histories of congestive heart failure, cerebrovascular disease, peptic ulcers, malignancy, hypertension, and hyperlipidemia. The NC group had similar 30-day mortality but a significantly shorter hospital stay and lower overall cost than the CC group, and a higher proportion but not statistically significant (p = 0.056) of overall biliary complications. A history of biliary complications was a risk factor for biliary complications. Concomitant cholecystectomy did not significantly prevent biliary complications, including benign biliary events or malignancy.
CONCLUSION: Receiving concomitant cholecystectomy provided minimal benefit in reducing the long-term risk of biliary complications or malignancy. Therefore, the benefits of concomitant cholecystectomy during gallstone ileus treatment should be carefully evaluated.