Cholecystectomy, gallstones, tonsillectomy, and pancreatic cancer risk: a population-based case-control study in minnesota

Abstract

Background:Associations between medical conditions and pancreatic cancer risk are controversial and are thus evaluated in a study conducted during 1994–1998 in Minnesota.Methods:Cases (n=215) were ascertained from hospitals in the metropolitan area of the Twin Cities and the Mayo Clinic. Controls (n=676) were randomly selected from the general population and frequency matched to cases by age and sex. The history of medical conditions was gathered with a questionnaire during in-person interviews. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression.Results:After adjustment for confounders, subjects who had cholecystectomy or gallstones experienced a significantly higher risk of pancreatic cancer than those who did not (OR (95% CI): 2.11 (1.32–3.35) for cholecystectomy and 1.97 (1.23–3.12) for gallstones), whereas opposite results were observed for tonsillectomy (0.67 (0.48–0.94)). Increased risk associated with cholecystectomy was the greatest when it occurred ⩽2 years before the cancer diagnosis (5.93 (2.36–15.7)) but remained statistically significant when that interval was ⩾20 years (2.27 (1.16–4.32)).Conclusions:Cholecystectomy, gallstones, and tonsillectomy were associated with an altered risk of pancreatic cancer. Our study suggests that cholecystectomy increased risk but reverse causality may partially account for high risk associated with recent cholecystectomy.

Cholecystectomy and the risk of alimentary tract cancers: A systematic review

“…In general, case-control studies are more susceptible to selection bias than are cohort studies. This is mainly due to the increased surveillance of patients in cohort studies which is less likely to distort the true effect [31] . Secondly, the majority of studies did not stipulate or report criteria for disease ascertainment.…”

“…The results obtained from these studies are contradictory. A significantly increased risk between previous cholecystectomy and pancreatic cancer was found in four case control studies [21,[30][31][32] and four cohort studies [33][34][35][36] . However, no association was found among nine case-control studies [37][38][39][40][41][42][43][44][45] and six cohort studies [22,26,29,[46][47][48] .…”

Gallstones, Cholecystectomy and the Risk of Hepatobiliary and Pancreatic Cancer: A Nationwide Population-based Cohort Study in Korea

“…Hypertrophy of the pancreas due to stimulation by the cholecystokinin enzyme circulating throughout the body and excessive generation of cells following cholecystectomy have been proposed as mechanisms that increase the risks of pancreatic cancer [4,28]. However, other studies explain the correlation between cholecystectomy and cancer in the relevant areas with inverse correlation or detection bias [29,30].…”

A New Approach to Accomplish Intraoperative Cholangiography in Left Lateral Segmentectomy of Living Liver Donation

“…The downside is that the removal of a healthy gallbladder can have unintended consequences. According to reports in the literature, post-cholecystectomy syndrome (PCS) occurs in 5–47% of patients after cholecystectomy [17,18] and the incidence of gastrointestinal tumors is also increased [19,20].…”