title: Recurrence of gallstones after cholecystectomy is associated with ABCG5/8 genotype.
abstract: BACKGROUND
  Gallstone disease is a frequent and economically highly relevant disorder, with cholecystectomy representing one of the most frequently performed operations world-wide. Gallstone recurrence after cholecystectomy is associated with complications such as biliary sepsis and pancreatitis. As yet, variant ABCG8-D19H is the most widely recognized genetic risk factor for gallstone disease. The aim of the study is to investigate whether ABCG8-D19H is associated with gallstone recurrence after cholecystectomy.
  
  
  METHODS
  Two thousand three hundred and eight patients from an earlier study of gallstone risk factors were re-contacted by mail, leading to 1,915 patients with available clinical and genetic information. Symptomatic gallstone recurrence was established if it occurred more than six months after surgery. Median follow-up time after cholecystectomy was eight years.
  
  
  RESULTS
  Gallstones recurred in 37 patients (1.9%). ABCG-D19H was found to be significantly associated with gallstone recurrence (p = 0.034). The allelic odds ratio was 1.97 (95% CI 1.12-∞). In a multivariate logistic regression analysis adjusted for age, sex, BMI and type of surgery, ABCG8-D19H remained a significant predictor, both in the total cohort (p = 0.024) and in the subgroup for whom information on type and scheduling of surgery was available (N = 1,650, p = 0.020).
  
  
  CONCLUSIONS
  ABCG8-D19H is a predictor of gallstone recurrence, a major long term postoperative biliary complication. Moreover, the observed association also reemphasizes the importance of the sterolin transporter for stone formation.
authors.affiliation: Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 6, 24105, Kiel, Germany.
authors.forename: Witigo
authors.initials: W
authors.lastname: von Schönfels
authors.forename: Stephan
authors.initials: S
authors.lastname: Buch
authors.forename: Maren
authors.initials: M
authors.lastname: Wölk
authors.forename: Heiko
authors.initials: H
authors.lastname: Aselmann
authors.forename: Jan H
authors.initials: JH
authors.lastname: Egberts
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
authors.forename: Michael
authors.initials: M
authors.lastname: Krawczak
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Jochen
authors.initials: J
authors.lastname: Hampe
authors.forename: Clemens
authors.initials: C
authors.lastname: Schafmayer
mesh_terms: D000071018:ATP Binding Cassette Transporter, Subfamily G, Member 5; D000071019:ATP Binding Cassette Transporter, Subfamily G, Member 8; D018528:ATP-Binding Cassette Transporters / Q000235:genetics*; D002763:Cholecystectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000235:genetics* / Q000601:surgery; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008074:Lipoproteins / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors
chemical_list: C416945:ABCG5 protein, human; C416946:ABCG8 protein, human; D000071018:ATP Binding Cassette Transporter, Subfamily G, Member 5; D000071019:ATP Binding Cassette Transporter, Subfamily G, Member 8; D018528:ATP-Binding Cassette Transporters; D008074:Lipoproteins