Year-end Sale % OFF 
Abstract
BackgroundThe risk of gallstone disease necessitating cholecystectomy after ileal resection (IR) in Crohn’s disease (CD) patients is not well established. We studied the incidence, cumulative and relative risk of cholecystectomy after IR in CD patients, and associated risk factors. MethodsCD patients with a first IR between 1991 and 2015 were identified in PALGA, a nationwide pathology database in the Netherlands. Details on subsequent cholecystectomy and IR were recorded. Yearly cholecystectomy rates from the general Dutch population were used as a reference. ResultsA cohort of 8302 (3466 (41.7%) males) CD patients after IR was identified. During the 11.9 (IQR 6.3–18.0) years median follow-up, the post-IR incidence rate of cholecystectomy was 5.2 (95% CI 3.5–6.4)/1000 persons/year. The cumulative incidence was 0.5% at 1 year, 2.4% at 5 years, 4.6% at 10 years, and 10.3% after 20 years. In multivariable analyses, female sex (HR 1.9, CI 1.5–2.3), a later calendar year of first IR (HR/5-year increase, HR 1.27, CI 1.18–1.35), and ileal re-resection (time-dependent HR 1.37, CI 1.06–1.77) were associated with cholecystectomy. In the last decade, cholecystectomy rates increased and were higher in our postoperative CD population than in the general population (relative incidence ratio 3.13 (CI 2.29–4.28; p < 0.0001) in 2015). ConclusionsAlthough higher in females, increasing in recent years, and higher than in the general population, the overall risk of cholecystectomy in CD patients following IR is low and routine prophylactic measures seem unwarranted.
Highlights
The annual incidence of newly diagnosed gallstones in Crohn’s disease (CD) patients is twice as high as compared to the general population.[1]
It has been well established that CD patients are at an increased risk of gallstone development, especially those with ileal involvement
The clinical relevance of this observed increase has remained unclear. This large nationwide long-term follow-up study is the first to assess the risk of gallstone disease necessitating an intervention following ileal resection (IR), namely cholecystectomy
Summary
The annual incidence of newly diagnosed gallstones in Crohn’s disease (CD) patients is twice as high as compared to the general population.[1] Ileal disease localization and previous ileal resection (IR) have both been identified as risk factors for developing gallstones in CD patients.[1,2] The underlying pathophysiology for the increased risk of developing gallstones in CD patients with ileal disease or after IR is not fully understood. A high risk of cholecystectomy after IR justifies increased alertness in symptomatic CD patients and possibly even prophylactic measures at the time of IR, such as synchronous cholecystectomy In this nationwide long-term follow-up study in the Netherlands, we aimed to assess the risk of—and identify risk factors for— cholecystectomy during long-term follow-up after IR in CD patients, including absolute annual and cumulative risk as well as the relative risk as compared to the general population. Conclusions higher in females, increasing in recent years, and higher than in the general population, the overall risk of cholecystectomy in CD patients following IR is low and routine prophylactic measures seem unwarranted
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
