| Abstract: | Background and Aims: Cholelithiasis is associated with several risk factors. Moreover, cholelithiasis
and choledocholithiasis share some risk factors. The risk stratification of pure gallbladder (GB) stones,
as well as GB stones with common bile duct (CBD) stones and pure CBD stones requiring therapeutic
endoscopic retrograde cholangiopancreatography (ERCP), has not been fully elucidated.
Methods: From Taiwan’s National Health Insurance Research Database (NHIRD), we identified 20671
cholelithiasis patients and 62013 control subjects (matched by sex and age in 1:3 ratio) during the period
2004-2011. We compared the risk factors for cholelithiasis patients and normal control group. Further
evaluations were performed on patients with pure GB stones and patients with GB and CBD stones and
patients with pure CBD stones who underwent therapeutic ERCP.
Results: Coronary artery disease, hyperlipidemia, chronic kidney disease, end stage renal disease on
regular hemodialysis, hepatitis B infection, liver cirrhosis, diabetes mellitus, and hemolysis were risk
factors for cholelithiasis. Risk factors for GB and CBD stone patients needing ERCP included male
gender (odds ratio: 1.211, 95% CI: 1.039-1.436, p value = 0.015), age over 60 (odds ratio: 1.912, 95%
CI: 1.492-2.450, p value <0.001), and hemolysis (odds ratio: 1.719, 95% CI: 1.008-2.929, p value =
0.047). For pure CBD stone patients needing ERCP, risk factors were male gender (odds ratio: 1.496,
95% CI: 1.195-1.874, p value <0.001), age 41-60 (odds ratio: 2.344, 95% CI: 1.503-3.654, p value
<0.001), and age over 60 (odds ratio: 4.484, 95% CI: 2.896-6.943, p value <0.001). There was lower
incidence of pure CBD stones requiring ERCP among those with hyperlipidemia (odds ratio: 0.613,
95% CI: 0.469-0.802, p value <0.001).
Conclusion: Male gender and advanced age play
significant roles in the requirement for therapeutic
ERCP among cholelithiasis patients.
Keywords: gallstones; choledocholithiasis; risk
factors |
