title: Cholecystectomy Reduces Recurrent Pancreatitis and Improves Survival After Endoscopic Sphincterotomy.
abstract: The aim of this study was to assess whether cholecystectomy can decrease the recurrent pancreatitis in the elderly patients who received endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) and successful clearance of bile duct (BD) stones after gallstone-related acute pancreatitis.
  
  
  
  We analyzed data from National Health Insurance Research Database of Taiwan. Elderly patients (age ≧70 years old) who had gallstone-related acute pancreatitis and underwent successful EST with BD stones clearance were eligible for enrollment. This nationwide, population-based, propensity score (PS)-matched cohort study involved two cohorts: (1) patients who underwent cholecystectomy after ERCP with BD stone clearance as study group and (2) those who adopted wait-and-see strategy (without cholecystectomy) after ERCP with BD stone clearance as control group. The primary and secondary endpoints were recurrent acute pancreatitis and all-cause mortality, respectively.
  
  
  
  During the study period, a total of 670 elderly patients (male 291, female 379) with a mean age of 79.1 was enrolled for analysis after PS matching. The incidence rate of recurrent acute pancreatitis was 12.39 per 1000 person-years in the cholecystectomy cohort and 23.94 per 1000 person-years in the PS-matched control cohort. The risk of recurrent acute pancreatitis was significantly lower in the cholecystectomy cohort (HR, 0.56; 95 % confidence interval [CI], 0.34-0.91; P = 0.021). The HR for all-cause mortality among the cholecystectomy cohort was 0.75 (95 % CI, 0.59-0.95; P = 0.016) compared with the control cohort.
  
  
  
  Cholecystectomy decreased the subsequent recurrent acute pancreatitis and the all-cause mortality in elderly patients with EST and clearance of BD stones after gallstone-related acute pancreatitis.
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.
authors: Shih-Hao
authors: SH
authors: Young
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.
authors: Yen-Ling
authors: YL
authors: Peng
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.
authors: Xi-Hsuan
authors: XH
authors: Lin
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. ytchen0117@gmail.com.|Department of Medicine, Taipei City Hospital Heping Fuyou Branch, 33, Zhonghua Road, Section 2, Taipei, Taiwan. ytchen0117@gmail.com.
authors: Yung-Tai
authors: YT
authors: Chen
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. jcluo@vghtpe.gov.tw.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan. jcluo@vghtpe.gov.tw.|Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan. jcluo@vghtpe.gov.tw.
authors: Jiing-Chyuan
authors: 0000-0003-4306-5464
authors: JC
authors: Luo
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yen-Po
authors: YP
authors: Wang
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.|Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Ming-Chih
authors: MC
authors: Hou
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.
authors: Fa-Yauh
authors: FY
authors: Lee
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D057216:Propensity Score; D012008:Recurrence; D055502:Secondary Prevention; D016717:Sphincterotomy, Endoscopic / Q000401:mortality
keywords: Acute pancreatitis; Cholecystectomy; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Gallstones