Dataset Information

Cholecystectomy Risk in Crohn's Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study.

ABSTRACT:

Background

The risk of gallstone disease necessitating cholecystectomy after ileal resection (IR) in Crohn's disease (CD) patients is not well established. We studied the incidence, cumulative and relative risk of cholecystectomy after IR in CD patients, and associated risk factors.

Methods

CD patients with a first IR between 1991 and 2015 were identified in PALGA, a nationwide pathology database in the Netherlands. Details on subsequent cholecystectomy and IR were recorded. Yearly cholecystectomy rates from the general Dutch population were used as a reference.

Results

A cohort of 8302 (3466 (41.7%) males) CD patients after IR was identified. During the 11.9 (IQR 6.3-18.0) years median follow-up, the post-IR incidence rate of cholecystectomy was 5.2 (95% CI 3.5-6.4)/1000 persons/year. The cumulative incidence was 0.5% at 1 year, 2.4% at 5 years, 4.6% at 10 years, and 10.3% after 20 years. In multivariable analyses, female sex (HR 1.9, CI 1.5-2.3), a later calendar year of first IR (HR_{/5-year increase}, HR 1.27, CI 1.18-1.35), and ileal re-resection (time-dependent HR 1.37, CI 1.06-1.77) were associated with cholecystectomy. In the last decade, cholecystectomy rates increased and were higher in our postoperative CD population than in the general population (relative incidence ratio 3.13 (CI 2.29-4.28; p?ConclusionsAlthough higher in females, increasing in recent years, and higher than in the general population, the overall risk of cholecystectomy in CD patients following IR is low and routine prophylactic measures seem unwarranted.

SUBMITTER: Goet JC

PROVIDER: S-EPMC6702183 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cholecystectomy Risk in Crohn's Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study.

Goet Jorn C JC Beelen Evelien M J EMJ Biermann Katharina E KE Gijsbers Annette H AH Schouten W Rudolph WR van der Woude C Janneke CJ de Vries Annemarie C AC

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 20181108 9

<h4>Background</h4>The risk of gallstone disease necessitating cholecystectomy after ileal resection (IR) in Crohn's disease (CD) patients is not well established. We studied the incidence, cumulative and relative risk of cholecystectomy after IR in CD patients, and associated risk factors.<h4>Methods</h4>CD patients with a first IR between 1991 and 2015 were identified in PALGA, a nationwide pathology database in the Netherlands. Details on subsequent cholecystectomy and IR were recorded. Yearl ...[more]

PMID: 30411310

Similar Datasets

Project description:Use of exogenous hormones, in the form of oral contraceptives (OCs), has been linked consistently to risk of Crohn's disease (CD). Nonetheless, it is not clear how OCs might contribute to the progression of CD.We conducted a prospective study of female patients with CD (age, 16-51 y), identified from the inpatient and outpatient care components of the Swedish National Patient Register from January 2002 through December 2013. Information on current OC use was obtained from the Prescribed Drug Register starting in July of 2005 and updated until December of 2013. Primary outcomes were defined as first CD-related surgery and first steroid prescription. We used Cox proportional hazard modeling with time-varying covariates to estimate multivariable-adjusted hazard ratios (MV-adjusted HRs).We identified 482 incident cases of surgery among 4036 patients with CD, with a median follow-up period of 58 months. Compared with nonusers, the MV-adjusted HRs for surgery were 1.14 (95% confidence interval [CI], 0.80-1.63) for past users and 1.30 (95% CI, 0.89-1.92) for current users. The risk of surgery increased with longer duration of use (Ptrend = .036) and higher prescribed daily dose (Ptrend = .016). Specifically, for women with more than 3 years of OC use, the MV-adjusted HR for surgery was 1.68 (95% CI, 1.06-2.67). The association was confined to the combination type of OC. We estimated that for every 83 patients with CD receiving the combination type of oral contraceptives for at least 1 year, 1 extra surgery is required. The rate of steroid prescriptions did not appear to increase with past or current use of OCs, compared with patients who have not taken OCs (all Pcomparisons > .20).In a nationwide analysis of patients in Sweden, long-term use of OCs, particularly the combination type, was associated with an increased risk of surgery among women with established CD. Clinicians carefully should evaluate and monitor contraceptive options among women with established CD.

Dataset Information

Cholecystectomy Risk in Crohn's Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study.

Background

Methods

Results

Publications

Cholecystectomy Risk in Crohn's Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study.

Similar Datasets

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