Risk of cholangiocarcinoma in patients undergoing therapeutic endoscopic retrograde cholangiopancreatography or cholecystectomy: A population based study

Table 1 Demographic data of study and normal population

	Cholelithiasis group n = 7938		Control group n = 23814		P value
	N	SD, %	N	SD, %
Age, mean (SD)	59.15	16.53	59.15	16.53	1
Age, yr
18-49	38.89	7.38	38.94	7.38
50-69	59.13	5.52	59.13	5.52
> 70	78.67	5.95	78.67	5.95
Gender					1
Male	3798	47.85	11394	47.85
Female	4140	52.15	12420	52.15
Follow up time (mo), mean (SD)	57.96	21.48	63.12	15.6	< 0.001
Economic status					< 0.001
MBS	3963	49.92	11216	47.1
1-3 times MBS	3136	39.51	10217	42.9
Above 3 times MBS	825	10.39	2336	9.81
Place of residence					0.007
City	5046	63.57	15078	63.32
Countryside	2747	34.61	8403	35.29
Remote village	131	1.65	287	1.21
Comorbidity
CHB	754	9.5	667	2.8	< 0.001
CHC	542	6.83	474	1.99	< 0.001
HP	128	1.61	131	0.55	< 0.001
DM	2319	29.21	4327	18.17	< 0.001
ESRD	186	2.34	357	1.5	< 0.001
CCDL	51	0.64	7	0.03	< 0.001
CO	0	0	0	0	NA
IBD	119	1.5	184	0.77	< 0.001
Cholangiocarcinoma
Number (rate)	147	1.85	39	0.16	< 0.001
Follow up time (mo), mean (SD)	13.92	21.96	31.8	21.48	< 0.001
Cholangiocarcinoma after first 6 mo
Number (rate)	55	0.69	35	0.15	< 0.001
Follow up time (mo), mean (SD)	36.73	20.57	35.27	19.94	0.86

SD: Standard deviation; MBS: Minimum basic salary; CHB: Chronic hepatitis B; CHC: Chronic hepatitis C; HP: Helicobacter infection; DM: Diabetes mellitus; ESRD: End-stage renal disease; CCDL: Congenital cystic disease of liver; CO: Clonorchis Opisthorchis; IBD: Inflammatory bowel disease.

Table 2 The comparisons of cholelithiasis patients underwent therapeutic endoscopic retrograde cholangiopancreatography, cholecystectomy or no intervention

	ES/EPBD n = 537		Cholecystectomy n = 1743		Without intervention n = 5658		P value
	N	SD, %	N	SD, %	N	SD, %
Age, mean (SD)	64.33	16.33	56.95	16.53	59.34	16.43	0.941
Age, yr
18-49	39.29	7.59	38.26	7.6	39.09	7.27	0.391
50-69	60	5.2	59.3	5.56	58.99	5.53	0.559
> 70	79.11	5.73	78.01	5.54	78.78	6.08	0.002
Gender							0.692
Male	264	49.16	843	48.36	2691	47.56
Female	273	50.84	900	51.64	2967	52.44
Follow up time (mo), mean (SD)	56.3	22.24	61.38	18.4	56.88	22.27	< 0.001
Economic status							0.16
MBS	319	59.4	1137	65.23	3590	63.45
1-3 times MBS	209	38.92	574	32.93	1964	34.71
Above 3 times MBS	9	1.68	28	1.61	94	1.66
Place of residence							0.009
City	296	55.12	854	49	2813	49.72
Countryside	205	38.18	681	39.07	2250	39.77
Remote village	36	6.7	204	11.7	585	10.34
Comorbidity
CHB	50	9.31	137	7.86	567	10.02	0.026
CHC	22	4.1	73	4.19	447	7.9	< 0.001
HP	11	2.05	23	1.32	94	1.66	0.433
DM	167	31.1	478	27.42	1674	29.59	0.135
ESRD	12	2.23	37	2.12	137	2.42	0.76
CCDL	13	2.42	12	0.69	26	0.46	< 0.001
CO	0	0	0	0	0	0	NA
IBD	6	1.12	23	1.32	90	1.59	0.54
Cholangiocarcinoma
Number of cholangiocarcinoma	27	5.03	15	0.86	105	1.86	< 0.001
Number of cholangiocarcinoma after first 6 mo	11	2.05	7	0.4	37	0.65	< 0.001
Odds ratio	3.13		0.61		1
Number of cholangiocarcinoma after first 12 mo	10	1.86	6	0.34	35	0.62	< 0.001
Odds ratio	3.01		0.56		1
Time to diagnosis of cholangiocarcinoma (excluding case in initial 6 mo), month	41.17	22.51	33.7	23.35	35.46	19.08	0.698

SD: Standard deviation; MBS: Minimum basic salary; CHB: Chronic hepatitis B; CHC: Chronic hepatitis C; HP: Helicobacter infection; DM: Diabetes mellitus; ESRD: End-stage renal disease; CCDL: Congenital cystic disease of liver; CO: Clonorchis Opisthorchis; IBD: Inflammatory bowel disease.

Table 3 Incidence of cholangiocarcinoma amount patient with cholelithiasis underwent therapeutic endoscopic retrograde cholangiopancreatography, cholecystectomy or no intervention compared with normal population (excluding cholangiocarcinoma in the initial 6 mo)

Variables	Person-years at risk in study cohort	Person-years at risk in control cohort	No. of observed cases of cholangiocarcinoma in study cohort	No. of observed cases of cholangiocarcinoma in control cohort	Incidence rate/1000 person-years (95%CI) in study cohort	Incidence rate/1000 person-years (95%CI) in control cohort
ES/EPBD
Total	2519.33	125339.21	11	35	4.37 (2.30-7.59)	0.28 (0.20-0.38)
Gender
Male	1252.12	59176.6	3	20	2.40 (0.61-6.52)	0.34 (0.21-0.51)
Female	1267.21	66162.61	8	15	6.31 (2.93-11.99)	0.23 (0.13-0.37)
Age, yr
18-49	561.74	37789.95	1	5	1.78 (0.09-8.78)	0.13 (0.05-0.29)
50-69	895.32	48272.57	2	14	2.23 (0.38-7.38)	0.29 (0.17-0.48)
> 70	1062.27	39276.69	8	16	7.53 (3.50-14.30)	0.41 (0.24-0.65)
Cholecystectomy
Total	8911.32	125339.21	7	35	0.79 (0.34-1.55)	0.28 (0.20-0.38)
Gender
Male	4187.56	59176.6	3	20	0.72 (0.18-1.95)	0.34 (0.21-0.51)
Female	4723.76	66162.61	4	15	0.85 (0.27-2.04)	0.23 (0.13-0.37)
Age, yr
18-49	3173.23	37789.95	1	5	0.32 (0.02-1.55)	0.13 (0.05-0.29)
50-69	3413.76	48272.57	1	14	0.29 (0.01-1.45)	0.29 (0.17-0.48)
> 70	2324.33	39276.69	5	16	2.15 (0.79-4.77)	0.41 (0.24-0.65)
Cholelithiasis without intervention
Total	26820.41	125339.21	37	35	1.38 (0.99-1.88)	0.28 (0.20-0.38)
Gender
Male	12201.3	59176.6	21	20	1.72 (1.09-2.59)	0.34 (0.21-0.51)
Female	14619.11	66162.61	16	15	1.09 (0.65-1.74)	0.23 (0.13-0.37)
Age, yr
18-49	8423.77	37789.95	4	5	0.48 (0.15-1.15)	0.13 (0.05-0.29)
50-69	10889.04	48272.57	12	14	1.10 (0.60-1.87)	0.29 (0.17-0.48)
> 70	7507.6	39276.69	21	16	2.80 (1.78-4.20)	0.41 (0.24-0.65)

ES/EPBD: Endoscopic sphincterotomy/endoscopic papillary balloon dilatation.