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Cholecystectomy as a risk factor for oesophageal adenocarcinoma
Tue - August 30, 2011 9:10 pm  |  Article Hits:3693  |  A+ | a-
Cholecystectomy is a common surgical procedure in Western society, although oesophageal adenocarcinoma is rare and the identified association weak. Thus, the absolute increased risk in an individual undergoing cholecystectomy is negligible. Therefore, the study cannot be used to guide clinical decision-making among unselected patients. Moreover, cholecystectomy is an important treatment for patients affected by complications of gallstone disease, such as pancreatitis or cholecystitis. In many patients who undergo cholecystectomy, however, the indication is relative or uncertain. Many patients who have had a cholecystectomy have a history of recurrent abdominal pain and gallstones detected during ultrasonography, but this is also a common combination in patients without gallstone problems.

The present study lends some support to the decision to avoid cholecystectomy in patients with reflux where the indications for the surgery are uncertain. There is no obvious reason why the results of this study cannot be generalized to populations other than the Swedish. The mechanisms suggested should not be linked with, for example, ethnicity. This large population-based study with a long and complete follow-up has indicated that cholecystectomy is associated with an increased risk of oesophageal adenocarcinoma. Causality cannot be proven by one study alone, but is supported by the significant association that appeared to increase with longer exposure time, the lack of obvious confounding (by obesity) or detection bias, the findings from previous research, and the likely biological mechanisms. Cholecystectomy as a risk factor for oesophageal adenocarcinoma J. Lagergren1,2,*, F. Mattsson1 Article first published online: 17 MAY 2011 DOI: 10.1002/bjs.7504

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