Abstract
The aetiology of cancer of the extrahepatic bile duct is unknown. Gallstones have been proposed to be a risk factor on the basis of ecological and epidemiological evidence. As gallstones are formed in the gallbladder, the occurrence of extrahepatic bileduct cancer in patients after cholecystectomy is of interest. All patients (62 734) who had had a cholecystectomy during 1965-1983 within the Uppsala Health Care Region, Sweden, were followed up to the end of 1987. Excluding the first year of follow-up, 23 cancers of the extrahepatic bileduct occurred vs 26.3 expected for a standardised incidence ratio (SIR) of 0.88 (95% confidence interval [CI] 0.56-1.31). Ten years or more after operation there was a greater reduction of risk (SIR = 0.27; 95% CI 0.06-0.80). Similar patterns were observed for men and women, and among patients who had undergone cholecystectomy only compared with those who had had their common bileducts explored. To assess surveillance bias the incidence of primary liver cancer was also analysed: SIR = 1.15; 95% CI 0.91-1.44 overall, and 10 years or more after cholecystectomy SIR = 0.98; 95% CI 0.66-1.40. This study shows a reduced risk of extrahepatic bileduct cancer 10 or more years after cholecystectomy, indicating that gallstones may be a cause of this cancer.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1533-1534 |
| Number of pages | 2 |
| Journal | Hepatology |
| Volume | 19 |
| Issue number | 6 |
| State | Published - Jun 1994 |
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ASJC Scopus subject areas
- Hepatology
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Cholecystectomy protects against extrahepatic bile duct cancer : Is this a result of the removal of gallstones?. Ekbom A, Hsieh C-C, Yuen J, Trichopoulous D, McLaughlin JK, Lan S-J, Adami H-O. Risk of extrahepatic bile duct cancer after cholecystectomy. Lancet 1993;342:1262-1265. / Walden, David T.; Soloway, Roger D.; Crowther, Roger S.
In: Hepatology, Vol. 19, No. 6, 06.1994, p. 1533-1534.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cholecystectomy protects against extrahepatic bile duct cancer
T2 - Is this a result of the removal of gallstones?. Ekbom A, Hsieh C-C, Yuen J, Trichopoulous D, McLaughlin JK, Lan S-J, Adami H-O. Risk of extrahepatic bile duct cancer after cholecystectomy. Lancet 1993;342:1262-1265
AU - Walden, David T.
AU - Soloway, Roger D.
AU - Crowther, Roger S.
PY - 1994/6
Y1 - 1994/6
N2 - The aetiology of cancer of the extrahepatic bile duct is unknown. Gallstones have been proposed to be a risk factor on the basis of ecological and epidemiological evidence. As gallstones are formed in the gallbladder, the occurrence of extrahepatic bileduct cancer in patients after cholecystectomy is of interest. All patients (62 734) who had had a cholecystectomy during 1965-1983 within the Uppsala Health Care Region, Sweden, were followed up to the end of 1987. Excluding the first year of follow-up, 23 cancers of the extrahepatic bileduct occurred vs 26.3 expected for a standardised incidence ratio (SIR) of 0.88 (95% confidence interval [CI] 0.56-1.31). Ten years or more after operation there was a greater reduction of risk (SIR = 0.27; 95% CI 0.06-0.80). Similar patterns were observed for men and women, and among patients who had undergone cholecystectomy only compared with those who had had their common bileducts explored. To assess surveillance bias the incidence of primary liver cancer was also analysed: SIR = 1.15; 95% CI 0.91-1.44 overall, and 10 years or more after cholecystectomy SIR = 0.98; 95% CI 0.66-1.40. This study shows a reduced risk of extrahepatic bileduct cancer 10 or more years after cholecystectomy, indicating that gallstones may be a cause of this cancer.
AB - The aetiology of cancer of the extrahepatic bile duct is unknown. Gallstones have been proposed to be a risk factor on the basis of ecological and epidemiological evidence. As gallstones are formed in the gallbladder, the occurrence of extrahepatic bileduct cancer in patients after cholecystectomy is of interest. All patients (62 734) who had had a cholecystectomy during 1965-1983 within the Uppsala Health Care Region, Sweden, were followed up to the end of 1987. Excluding the first year of follow-up, 23 cancers of the extrahepatic bileduct occurred vs 26.3 expected for a standardised incidence ratio (SIR) of 0.88 (95% confidence interval [CI] 0.56-1.31). Ten years or more after operation there was a greater reduction of risk (SIR = 0.27; 95% CI 0.06-0.80). Similar patterns were observed for men and women, and among patients who had undergone cholecystectomy only compared with those who had had their common bileducts explored. To assess surveillance bias the incidence of primary liver cancer was also analysed: SIR = 1.15; 95% CI 0.91-1.44 overall, and 10 years or more after cholecystectomy SIR = 0.98; 95% CI 0.66-1.40. This study shows a reduced risk of extrahepatic bileduct cancer 10 or more years after cholecystectomy, indicating that gallstones may be a cause of this cancer.
UR - http://www.scopus.com/inward/record.url?scp=0028228357&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028228357&partnerID=8YFLogxK
M3 - Article
C2 - 8188186
AN - SCOPUS:0028228357
VL - 19
SP - 1533
EP - 1534
JO - Hepatology
JF - Hepatology
SN - 0270-9139
IS - 6
ER -