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胆囊结石胆囊切除术后消化性溃疡风险增加。

Increased Risk of Peptic Ulcers Following a Cholecystectomy for Gallstones.

作者信息

Tsai Ming-Chieh, Huang Chung-Chien, Kao Li-Ting, Lin Herng-Ching, Lee Cha-Ze

机构信息

Division of Gastroenterology, Department of Internal Medicine, Hsinchu Cathay General Hospital, Taipei, Taiwan.

School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.

出版信息

Sci Rep. 2016 Jul 29;6:30702. doi: 10.1038/srep30702.

Abstract

This retrospective cohort study examined the relationship between a cholecystectomy and the subsequent risk of peptic ulcers using a population-based database. Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. This study included 5209 patients who had undergone a cholecystectomy for gallstones and 15,627 sex- and age-matched comparison patients. We individually tracked each patient for a 5-year period to identify those who subsequently received a diagnosis of peptic ulcers. We found that of the 20,836 sampled patients, 2033 patients (9.76%) received a diagnosis of peptic ulcers during the 5-year follow-up period: 674 from the study group (12.94% of the patients who underwent a cholecystectomy) and 1359 from the comparison group (8.70% of the comparison patients). The stratified Cox proportional hazard regressions showed that the adjusted hazard ratio (HR) for peptic ulcers during the 5-year follow-up period was 1.48 (95% CI = 1.34~1.64) for patients who underwent a cholecystectomy than comparison patients. Furthermore, the adjusted HRs of gastric ulcers and duodenal ulcers during the 5-year follow-up period were 1.70 and 1.71, respectively, for patients who underwent a cholecystectomy compared to comparison patients. This study demonstrated a relationship between a cholecystectomy and a subsequent diagnosis of peptic ulcers.

摘要

这项回顾性队列研究使用基于人群的数据库,检验了胆囊切除术与随后发生消化性溃疡风险之间的关系。本研究的数据取自2005年台湾纵向健康保险数据库。该研究纳入了5209例因胆结石接受胆囊切除术的患者以及15627例性别和年龄匹配的对照患者。我们对每位患者进行了为期5年的单独跟踪,以确定那些随后被诊断为消化性溃疡的患者。我们发现,在20836例抽样患者中,有2033例患者(9.76%)在5年随访期内被诊断为消化性溃疡:研究组中有674例(占接受胆囊切除术患者的12.94%),对照组中有1359例(占对照患者的8.70%)。分层Cox比例风险回归显示,在5年随访期内,接受胆囊切除术的患者发生消化性溃疡的调整风险比(HR)为1.48(95%CI = 1.34~1.64),高于对照患者。此外,在5年随访期内,接受胆囊切除术的患者发生胃溃疡和十二指肠溃疡的调整HR分别为1.70和1.71,高于对照患者。这项研究证明了胆囊切除术与随后消化性溃疡诊断之间的关系。

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