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Cholecystectomy reduces subsequent cholangiocarcinoma risk in choledocholithiasis patients undergoing endoscopic intervention

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World Journal of Gastrointestinal Oncology 2020年第12期12卷 1381-1393页

作者： Chi-Chih Wang Ming-Hseng Tseng Sheng-Wen Wu Tzu-Wei Yang Hsuan-Yi Chen Wen-Wei Sung Chang-Cheng Su Yao-Tung Wang Chun-Che Lin Ming-Chang Tsai Division of Gastroenterology and Hepatology Department of Internal MedicineChung Shan Medical University Hospitaland Institute of MedicineSchool of MedicineChung Shan Medical UniversityTaichung 40201Taiwan Department of Medical Informatics Chung Shan Medical UniversityTaichung 402Taiwan Department of Internal Medicine Chung Shan Medical University Hospital and School of MedicineChung Shan Medical UniversityTaichung 402Taiwan Department of Urology Chung Shan Medical University Hospitaland Institute of MedicineSchool of MedicineChung Shan Medical UniversityTaichung 40201Taiwan Division of Pulmonary Medicine Chung Shan Medical University Hospitaland Institute of MedicineSchool of MedicineChung Shan Medical UniversityTaichung 402Taiwan Department of Internal Medicine China Medical University Hospital and School of MedicineChina Medical UniversityTaichung 402Taiwan

BACKGROUND Cholangiocarcinoma is a disease with a high mortality *** 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 *** To clarify the relationship between recurrent biliary events and subsequent cholangiocarcinoma risk in choledocholithiasis *** 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 *** study group was further divided into ES/endoscopic papillary balloon dilatation,both ES/endoscopic papillary balloon dilatation and cholecystectomy,and no intervention *** 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,*** 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 *** Choledocholithiasis patients who undergo further cholecystectomy after ES/endoscopic papillary balloon dilatation have decreased subsequent cholangiocarcinoma risk due to reduced recurrent biliary events.

关键词： Cholangiocarcinoma Endoscopic sphincterotomy Endoscopic papillary balloon dilatation Cholecystectomy recurrent biliary events

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