title: Long-term risk of pancreatitis and diabetes after cholecystectomy in patients with cholelithiasis but no pancreatitis history: a 13-year follow-up study.
abstract: OBJECTIVE
  Patients with biliary pancreatitis are suggested to undergo cholecystectomy to prevent the recurrence of pancreatitis. However, it remains controversial whether cholecystectomy is associated with reduced risks of pancreatitis and diabetes in patients with cholelithiasis and no history of pancreatitis.
  
  
  METHODS
  From Taiwan's National Health Insurance Research Database, we identified the following cohorts and analyzed the long-term risks of pancreatitis and diabetes in each cohort: 1) cholecystectomy cohort: cholelithiasis patients who had no history of pancreatitis and diabetes and underwent cholecystectomy; and 2) comparison cohort: cholelithiasis patients who had no history of pancreatitis and diabetes and did not undergo cholecystectomy.
  
  
  RESULTS
  The cholecystectomy group and the comparison group had similar distributions of age, sex, and comorbidities, except for hyperlipidemia. The proportion of patients in the cholecystectomy group who underwent endoscopic cholangiographic procedures was higher than that in the comparison group. Cholecystectomy was associated with a reduced risk of pancreatitis (adjusted hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.36-0.68). Age-specific analyses showed that pancreatitis risk was decreased in patients younger than 50 and older than 65years. Both men and women exhibited reduced risks of pancreatitis after cholecystectomy. However, cholecystectomy was not associated with changes in the risk for diabetes.
  
  
  CONCLUSIONS
  Cholecystectomy for cholelithiasis is associated with a reduced risk of pancreatitis, but not of diabetes, in patients without previous history of pancreatitis and diabetes.
authors.affiliation: Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Tsai
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yao-Chun
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
authors.forename: Hui-Ming
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
keywords: Cholecystectomy; Cholelithiasis; Cohort study; National Health Insurance Research Database (NHIRD); Pancreatitis