Nationwide epidemiological study of severe gallstone disease in Taiwan.
BACKGROUND
Our study aimed to assess the nationwide trends in the incidence of severe gallstone disease in Taiwan among adults aged >or=20.


METHODS
A retrospective longitudinal study was conducted using Taiwan National Health Insurance Research Database collected during 1997-2005. Patients with incident severe gallstone disease (acute cholecystitis, biliary pancreatitis, acute cholangitis) and gallstone-related procedures (elective and non-elective cholecystectomy, endoscopic retrograde cholangiopancreatography [ERCP]) that led to hospital admission were identified using ICD-9-CM diagnostic and procedure codes. Annual incidence rates of gallstone-related complications and procedures were calculated and their 95% confidence intervals (CI) were estimated assuming a Poisson distribution.


RESULTS
The hospital admission rate for severe gallstone disease increased with advancing age and the age-standardized rate (95% CI) per 1000 population was 0.60 (0.59-0.60) for men and 0.59 (0.59-0.60) for women. Men had a higher rate of acute cholecystitis, probably due to the substantially lower rate of elective cholecystectomy among men than women. For those aged 20-39, hospital admissions for all gallstone-related complications and procedures increased significantly. For those aged >or=60, incidences of biliary pancreatitis, acute cholangitis, and hospital admission for gallstone receiving ERCP increased significantly without substantial change in the incidence of acute cholecystitis and despite a decreased rate of elective cholecystectomy.


CONCLUSIONS
This population-based study found a substantial increase in the rate of admission for severe gallstone disease among those aged 20-39. Concurrently, the incidences of biliary pancreatitis and acute cholangitis have risen among those aged >or=60.
Huang
John
J
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. docjohn@ntuh.gov.tw
Chang
Chia-Hsuin
CH
Wang
Juin-Ling
JL
Kuo
Hsu-Ko
HK
Lin
Jou-Wei
JW
Shau
Wen-Yi
WY
Lee
Po-Huang
PH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002761:Cholangitis / Q000453:epidemiology; D041881:Cholecystitis, Acute / Q000453:epidemiology; D005260:Female; D042882:Gallstones / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology
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