Abstract
ObjectivesTo evaluate the risk of fracture in individuals with a history of cholecystectomy in Korean population.MethodsIndividuals (n = 143,667) aged ≥ 40 y who underwent cholecystectomy between 2010 and 2015 and the controls (n = 255,522), matched by age and sex, were identified from the database of the Korean National Health Insurance Services. The adjusted hazard ratio (aHR) and 95% confidence interval (CI) of fracture were estimated following cholecystectomy, and a Cox regression analysis was performed.ResultsThe incidence rates of all fractures, vertebral, and hip fractures were 14.689, 6.483 and 1.228 cases per 1000 person-years respectively in the cholecystectomy group, whereas they were 13.862, 5.976, and 1.019 cases per 1000 person-years respectively in the control group. After adjustment for age, sex, income, place of residence, diabetes mellitus, hypertension, dyslipidemia, smoking, alcohol drinking, exercise, and body mass index, patients who underwent cholecystectomy showed an increased risk of all fractures, vertebral fractures, and hip fractures (aHR [95% CI]: 1.095 [1.059-1.132], 1.134 [1.078-1.193], and 1.283 [1.139-1.444] for all fractures, vertebral fractures, and hip fractures, respectively). The risk of vertebral fractures following cholecystectomy was more prominent in the young age group (40 to 49 y) than in the old age group (≥ 65 y) (1.366 [1.082-1.724] vs. 1.132 [1.063-1.206], respectively). However, the incidence of hip fractures following cholecystectomy was not affected by age.ConclusionIndividuals who underwent cholecystectomy have an increased risk of fracture. In the younger population, the risk of vertebral fractures may be further increased following cholecystectomy.
Highlights
Cholecystectomy is one of the most common surgical procedures and patients who have undergone cholecystectomy can be encountered in clinical practice
The risk of vertebral fractures following cholecystectomy was more prominent in the young age group (40 to 49 y) than in the old age group (≥ 65 y) (1.366 [1.082-1.724] vs. 1.132 [1.063-1.206], respectively)
The incidence of hip fractures following cholecystectomy was not affected by age
Summary
Cholecystectomy is one of the most common surgical procedures and patients who have undergone cholecystectomy can be encountered in clinical practice. In Korea, the cholecystectomies per 100,000 persons were 149 cases in 2018, which increased at the rate of 5.9% over 5 years. Cholecystectomy expense was ranked fifth of 33 major types of surgery. The most common cause of cholecystectomy was gallstones, followed by cholecystitis [1]. Laparoscopic cholecystectomy is the gold standard for the treatment of gallstone diseases after its initiation and is generally considered a safe and effective procedure that can be performed with minimal risk [2,3,4,5,6,7]. New emerging evidence suggests that cholecystectomy increases the risk of certain diseases such as metabolic syndrome or non-alcoholic fatty liver disease (NAFLD) [8,9,10,11,12]
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