(1) Background: Previous studies have raised concerns about a potential increase in pancreaticobiliary cancer risk after cholecystectomy, but few studies have focused on patients who undergo cholecystectomy after receiving endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. This study aims to clarify cancer risks in these patients, who usually require cholecystectomy, to reduce recurrent biliary events. (2) Methods: We conducted a nationwide cohort study linked to the National Health Insurance Research Database, the Cancer Registry Database, and the Death Registry Records to evaluate the risk of pancreaticobiliary cancers. All patients who underwent first-time therapeutic ERCP for choledocholithiasis from 2011 to 2017 in Taiwan were included. We collected the data of 13,413 patients who received cholecystectomy after endoscopic retrograde cholangiopancreatography and used propensity score matching to obtain the data of 13,330 patients in both the cholecystectomy and non-cholecystectomy groups with similar age, gender, and known pancreaticobiliary cancer risk factors. Pancreaticobiliary cancer incidences were further compared. (3) Results: In the cholecystectomy group, 60 patients had cholangiocarcinoma, 61 patients had pancreatic cancer, and 15 patients had ampullary cancer. In the non-cholecystectomy group, 168 cases had cholangiocarcinoma, 101 patients had pancreatic cancer, and 49 patients had ampullary cancer. The incidence rates of cholangiocarcinoma, pancreatic cancer, and ampullary cancer were 1.19, 1.21, and 0.3 per 1000 person-years in the cholecystectomy group, all significantly lower than 3.52 (p< 0.0001), 2.11 (p= 0.0007), and 1.02 (p< 0.0001) per 1000 person-years, respectively, in the non-cholecystectomy group. (4) Conclusions: In patients receiving ERCP for choledocholithiasis, cholecystectomy is associated with a significantly lower risk of developing pancreaticobiliary cancer
（1）背景：既往研究提示胆囊切除术后胰胆管癌风险可能增加，但针对因胆总管结石接受内镜逆行胰胆管造影（ERCP）后行胆囊切除术患者的研究较少。本研究旨在明确此类通常需接受胆囊切除术以降低胆道事件复发风险患者的癌症风险。（2）方法：我们通过关联全民健康保险研究数据库、癌症登记数据库及死亡登记记录开展全国性队列研究，评估胰胆管癌风险。纳入2011年至2017年台湾地区所有首次接受治疗性ERCP的胆总管结石患者。收集13,413例ERCP术后接受胆囊切除术患者数据，采用倾向评分匹配法获得年龄、性别及已知胰胆管癌危险因素相匹配的胆囊切除术组与非胆囊切除术组各13,330例患者数据，进一步比较两组胰胆管癌发病率。（3）结果：胆囊切除术组发生胆管癌60例、胰腺癌61例、壶腹癌15例；非胆囊切除术组分别为168例、101例、49例。胆囊切除术组胆管癌、胰腺癌、壶腹癌发病率分别为每1000人年1.19例、1.21例、0.3例，均显著低于非胆囊切除术组的每1000人年3.52例（p<0.0001）、2.11例（p=0.0007）和1.02例（p<0.0001）。（4）结论：在因胆总管结石接受ERCP的患者中，胆囊切除术与显著降低的胰胆管癌风险相关。
肿瘤(癌症)患者之家