標題: Risk of cholangiocarcinoma in patients undergoing therapeutic endoscopic retrograde cholangiopancre-atography or cholecystectomy: A population based study
作者: Wang, Chi-Chih
Tsai, Ming-Chang
Sung, Wen-Wei
Yang, Tzu-Wei
Chen, Hsuan-Yi
Wang, Yao-Tung
Su, Chang-Cheng
Tseng, Ming-Hseng
Lin, Chun-Che
生物科技學系
Department of Biological Science and Technology
關鍵字: Cholangiocarcinoma;Endoscopic sphincterotomy;Endoscopic papillary balloon dilatation;Cholecystectomy
公開日期: 15-Mar-2019
摘要: BACKGROUND Cholangiocarcinoma is a highly lethal disease that had been underestimated in the past two decades. Many risk factors are well documented for in cholangiocarcinoma, but the impacts of advanced biliary interventions, like endoscopic sphincterotomy (ES), endoscopic papillary balloon dilatation (EPBD), and cholecystectomy, are inconsistent in the previous literature. AIM To clarify the risks of cholangiocarcinoma after ES/EPBD, cholecystectomy or no intervention for cholelithiasis using the National Health Insurance Research Database (NHIRD). METHODS From data of NHIRD 2004-2011 in Taiwan, we selected 7938 cholelithiasis cases as well as 23814 control group cases (matched by sex and age in a 1:3 ratio). We compared the previous risk factors of cholangiocarcinoma and cholangiocarcinoma rate in the cholelithiasis and control groups. The incidences of total and subsequent cholangiocarcinoma were calculated in ES/EPBD patients, cholecystectomy patients, cholelithiasis patients without intervention, and groups from the normal population. RESULTS In total, 537 cases underwent ES/EPBD, 1743 cases underwent cholecystectomy, and 5658 cholelithiasis cases had no intervention. Eleven (2.05%), 37 (0.65%), and 7 (0.40%) subsequent cholangiocarcinoma cases were diagnosed in the ES/EPBD, no intervention, and cholecystectomy groups, respectively, and the odds ratio for subsequent cholangiocarcinoma was 3.13 in the ES/EPBD group and 0.61 in the cholecystectomy group when compared with the no intervention group. CONCLUSION In conclusion, symptomatic cholelithiasis patients who undergo cholecystectomy can reduce the incidence of subsequent cholangiocarcinoma, while cholelithiasis patients who undergo ES/EPBD are at a great risk of subsequent cholangiocarcinoma according to our findings.
URI: http://dx.doi.org/10.4251/wjgo.v11.i3.238
http://hdl.handle.net/11536/149033
ISSN: 1948-5204
DOI: 10.4251/wjgo.v11.i3.238
期刊: WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY
Volume: 11
起始頁: 238
結束頁: 249
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