Reduced risk of stroke following cholecystectomy: A nationwide population‐based study

Abstract

Background and Aim: Gallstones and stroke are common diseases worldwide. The relationship between gallstones and stroke has been documented in the literature. In this work, to characterize the risk of stroke among gallstone patients with and without cholecystectomy, we investigated the effects of cholecystectomy in a nationwide population-based retrospective cohort study. Methods: Data were obtained from Taiwan's National Health Insurance Research Database. The study comprised 155 356 gallstone patients divided into two groups: those with and without cholecystectomy. Results: During the study period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), 19 096 (17.8/1000 person-years) gallstone patients without cholecystectomy and 11 913 (10.6/1000 person-years) gallstone patients with cholecystectomy had a stroke. Following gallstone removal, the patients exhibited a significant decrease in the risk of overall stroke (hazard ratio [HR] = 0.60, 95% confidence interval [CI] = 0.59-0.61), ischemic stroke (HR = 0.59, 95% CI = 0.58-0.61), and hemorrhagic stroke (HR = 0.56, 95% CI = 0.53-0.59). Asymptomatic and symptomatic gallstone patients had lower overall stroke risk after cholecystectomy (HR = 0.64, 95% CI = 0.62-0.67 and HR = 0.57, 95% CI = 0.56-0.59) than did asymptomatic gallstone patients without cholecystectomy. Conclusions: This population-based cohort study demonstrated that cholecystectomy is related to reduce the risk of overall stroke, ischemic stroke, and hemorrhagic stroke. Preventive measures for stroke may be considered for gallstone patients, particularly those presenting risk factor(s) for stroke.

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

“…In reviewing the literature ( online supplemental table 1 ), there have been several epidemiological studies examining the effect of cholecystectomy on vascular diseases. 31–33 36–38 All our former studies from the same database supported the ameliorating effect of cholecystectomy on atherosclerotic diseases, including acute myocardial infarction (AMI), stroke, organic erectile erection, migraines. 31–33 36 However, we noted that the risks of atherosclerosis between non-GD group and GD group with cholecystectomy were quite heterogeneous in our studies, including being comparable for erection dysfunction, being greater for AMI in GD with cholecystectomy, and being lower for AD/AN in GD with cholecystectomy.…”

“… 31–33 36–38 All our former studies from the same database supported the ameliorating effect of cholecystectomy on atherosclerotic diseases, including acute myocardial infarction (AMI), stroke, organic erectile erection, migraines. 31–33 36 However, we noted that the risks of atherosclerosis between non-GD group and GD group with cholecystectomy were quite heterogeneous in our studies, including being comparable for erection dysfunction, being greater for AMI in GD with cholecystectomy, and being lower for AD/AN in GD with cholecystectomy. One study from Mexico showed the deteriorating effect of cholecystectomy on the development of CVD, but the comparison group was general population without GD, rather than the GD subjects without cholecystectomy.…”

“…21–23 Along with our former studies regarding the association of GD with stroke, erectile dysfunction and migraine, this study may portend that GD is a predictor or an independent risk factor of systemic atherosclerosis. 31–35 However, it requires more studies using other databases to confirm the association of GSD with atherosclerosis since our studies were conducted based on the same database (NHIRD).…”

Reduced Risk of Atrial Fibrillation Following Cholecystectomy: A Nationwide Population-Based Study

“…Conventionally, expectant management is the standard treatment for asymptomatic GD, except for patients with chronic hemolytic anemia or who are Native Americans (Ibrahim et al, 2018). Our previous findings have suggested that patients with GD have a high risk of stroke, but cholecystectomy reduces the risk of ischemic and hemorrhagic stroke among both asymptomatic and symptomatic patients (Wei et al, 2014(Wei et al, , 2019. Therefore, patients with GD should receive frequent cardiovascular checkups.…”

“…Gallstone disease (GD; cholelithiasis) is a common digestive disorder and significantly increases cardiovascular disease (CVD) risk (Bortnichak et al, 1985 ; Jiang et al, 2013 ; Olaiya et al, 2013 ; Wei et al, 2014 , 2019 ; Lv et al, 2015 ; Wirth et al, 2015 ; Zheng et al, 2016 , 2018 ; Fan et al, 2017 ; Upala et al, 2017 ; Fairfield et al, 2019 ). However, no studies on AF risk in patients with GD have been conducted.…”