Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Br J Surg. 2011 Aug;98(8):1133-7. doi: 10.1002/bjs.7504. Epub 2011 May 17.
Owing to an increased risk of oesophageal bile exposure after cholecystectomy, an association with oesophageal adenocarcinoma is possible. There are some data in support of this hypothesis, and the aim of this study was to ascertain whether the association could be confirmed.
A population-based cohort study was undertaken to compare the number of cases of oesophageal adenocarcinoma observed in a cohort of patients who have had a cholecystectomy in Sweden during 1965-2008 with the expected number, calculated from the entire Swedish population of corresponding age, sex and year. The risk of oesophageal adenocarcinoma was assessed by calculating the standardized incidence ratio (SIR) with 95 per cent confidence intervals.
The cholecystectomy cohort included 345 251 patients who were followed up for a mean of 15 years and contributed 4 854 969 person-years at risk. The total of 126 new cases of oesophageal adenocarcinoma was greater than expected (SIR 1.29, 1.07 to 1.53). The strength of the association between cholecystectomy and oesophageal adenocarcinoma tended to increase with longer follow-up after cholecystectomy. There was no association between cholecystectomy and oesophageal squamous cell carcinoma (SIR 0.93, 0.81 to 1.08), and in an unoperated cohort of 192 960 patients with gallstones no increased risk of oesophageal adenocarcinoma was identified (SIR 0.99, 0.71 to 1.35).
Cholecystectomy appears to be linked to an increased risk of oesophageal adenocarcinoma, but the absolute risk is small.
由于胆囊切除术后食管胆汁暴露的风险增加，因此可能与食管腺癌相关。有一些数据支持这一假说，本研究旨在确定这种关联是否可以得到证实。
进行了一项基于人群的队列研究，以比较在瑞典 1965 年至 2008 年间接受胆囊切除术的患者队列中观察到的食管腺癌病例数与从相应年龄、性别和年份的整个瑞典人群中计算出的预期数。通过计算标准化发病比（SIR）及其 95%置信区间来评估食管腺癌的风险。
胆囊切除术队列包括 345251 名患者，平均随访 15 年，累计风险暴露为 4854969 人年。总共发现 126 例新的食管腺癌病例，超过预期（SIR 1.29，1.07 至 1.53）。胆囊切除术与食管腺癌之间的关联强度随着胆囊切除术后随访时间的延长而趋于增加。胆囊切除术与食管鳞状细胞癌之间无关联（SIR 0.93，0.81 至 1.08），在 192960 例未手术的胆囊结石患者中也未发现食管腺癌风险增加（SIR 0.99，0.71 至 1.35）。
胆囊切除术似乎与食管腺癌风险增加有关，但绝对风险较小。
