Relationship of previous cholecystectomy to oesophagitis and gastroduodenal ulcers.

The association of previous cholecystectomy with duodenogastric reflux, oesophagitis and gastroduodenal ulcers was studied in a series of 918 outpatients subjected to upper gastrointestinal endoscopy. Endoscopic oesophagitis was found more frequently in the 125 cholecystectomized patients than in their controls (p = 0.004). More gastric ulcer patients and fewer duodenal ulcer patients were found among the cholecystectomized patients than among the controls, but the difference was not statistically significant (p = 0.25 and p = 0.06, respectively). In the 62 patients with oesophagitis, at endoscopy the incidence of previous cholecystectomy was higher than in the controls without oesophagitis (p = 0.002), and in the 167 duodenal ulcer patients there was a lower frequency of cholecystectomy than in the controls without duodenal ulcer (p = 0.03) When the patients with oesophagitis were excluded from the cholecystectomized patients there were more gastric ulcers and fewer duodenal ulcers in the series than in the matched controls (p = 0.05 and p = 0.09, respectively). The relative chances of cholecystectomized persons being endoscoped compared with non-cholecystectomized persons was estimated. It seems that cholecystectomized persons are 2.06-fold more likely to be endoscopied than non-operated persons. Despite this tendency, there was in this series an almost equal proportion of organic diseases in both the symptomatic cholecystectomized patients and the symptomatic non-operated controls, suggesting an even higher association of these diseases in cholecystectomized persons in general than the observed accumulation would indicate. The results of the present study suggest that in symptomatic outpatients a previous cholecystectomy is associated positively with oesophagitis and gastric ulcer, but not with duodenal ulcer.