Kim Young Ae, Kim Hak Jun, Kang Mee Joo, Han Sung-Sik, Park Hyeong Min, Park Sang-Jae
Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Department of Artificial Intelligence Convergence, Hallym University Graduate School, Chuncheon, Republic of Korea.
Sci Rep. 2025 Jan 2;15(1):411. doi: 10.1038/s41598-024-84781-7.
Given the increasing trend of cholecystectomy, it is imperative to reassess surgical and surveillance strategies in consideration of the potential long-term risks for digestive tract cancers. The objective of this study was to assess the risk of gastrointestinal (GI) and hepato-biliary-pancreatic (HBP) cancer incidence after cholecystectomy. The data for this cohort study was obtained from the National Health Insurance Service database in Korea. 715,872 patients who underwent cholecystectomy between 2004 and 2020 were compared to 1,431,728 individuals who did not underwent cholecystectomy after age, sex, and year of cholecystectomy was matched. The overall incidence rate ratio (IRR) for all GI and HBP cancers was 1.08 (95% C.I., 1.06-1.10). Specifically, the risk of diagnosis of extrahepatic bile duct cancer (IRR 1.92), intrahepatic bile duct cancer (1.78), hepatocellular carcinoma (1.22), and pancreatic cancer (1.13) was significantly increased in the cholecystectomy group. The highest IRR was observed within the 1-3 years following cholecystectomy. Subsequently, the risk of diagnosis gradually decreased and returned to a level comparable to that of the matched control group after 5 to 10 years. In conclusion, hepato-biliary-pancreatic cancer are frequently diagnosed subsequent to cholecystectomy. Too short period of post-cholecystectomy follow-up may hinder monitoring of hepato-biliary-pancreatic cancer occurrence.
鉴于胆囊切除术的趋势不断增加，考虑到消化道癌症的潜在长期风险，重新评估手术和监测策略势在必行。本研究的目的是评估胆囊切除术后胃肠道（GI）和肝胆胰（HBP）癌症的发病风险。这项队列研究的数据来自韩国国民健康保险服务数据库。将2004年至2020年间接受胆囊切除术的715,872例患者与1,431,728例未接受胆囊切除术的个体进行比较，后者在年龄、性别和胆囊切除年份方面进行了匹配。所有胃肠道和肝胆胰癌症的总体发病率比（IRR）为1.08（95%置信区间，1.06 - 1.10）。具体而言，胆囊切除组肝外胆管癌（IRR 1.92）、肝内胆管癌（1.78）、肝细胞癌（1.22）和胰腺癌（1.13）的诊断风险显著增加。胆囊切除术后1 - 3年内观察到最高的IRR。随后，诊断风险逐渐降低，5至10年后恢复到与匹配对照组相当的水平。总之，胆囊切除术后常诊断出肝胆胰癌症。胆囊切除术后随访时间过短可能会阻碍对肝胆胰癌症发生情况的监测。
