Background/objective Prophylactic endoloop or hemoclip application and endoscopic mucosal resection (EMR) have been usually performed for large pedunculated colorectal polyps. However, their comparison remains unclear. This study aimed to compare the efficacy and safety of the prophylactic pretreatment and EMR in the large pedunculated polyps. Methods We reviewed 1994 pedunculated polyps detected in Peking Union Medical College Hospital from 2012 to 2024. Large pedunculated polyps (head size ≥2.0 cm) receiving EMR or prophylactic closure before polypectomy were included. Polyp morphology, endoscopic procedural variables, and adverse events were compared using propensity score matching and inverse probability of treatment weights. Logistic regression was performed to analyze the risk factors of adverse events. Results 204 pedunculated polyps undergoing prophylactic pretreatment and 262 polyps resected via EMR were included. Less clips (P = 0.002) and lower operational material-related costs (P < 0.001) presented in the prophylactic closure group than the EMR group, while the procedural time was comparable (prophylactic closure vs. EMR: median 13.0 vs. 10.0 min, P = 0.059). There were no differences in postpolypectomy bleeding (15.2% vs. 12.5%, P = 0.466) and postpolypectomy coagulation syndrome (1.5% vs. 0.7%, P = 0.509) between the two groups. Stalk width ≥0.6 cm (OR = 2.34, P = 0.02), number of hemoclips (OR = 1.44, P < 0.01), procedure time ≥10 min (OR = 2.03, P = 0.08), and malignant lesion (OR = 1.74, P = 0.08) were associated with high risks of immediate bleeding. The endoscopic procedure did not affect the risks of immediate or delayed bleeding. Conclusion The prophylactic closure with hemoclip or endoloop and conventional EMR are both effective and safe methods for large pedunculated colorectal polyps. Prophylactic closure has advantages in the hemoclips demand and average procedure costs compared to EMR.

The diagnosis of autoimmune pancreatitis (AIP) is multidisciplinary. Pathological diagnosis is pivotal when distinguishing AIP from malignancies. In this study, we aim to compare the diagnostic performance and sample adequacy of 19-gauge endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) needles with 20-gauge endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needles in patients with suspected AIP. We conducted a single-centre, parallel-group, prospective, randomized controlled trial at Peking Union Medical College Hospital (Beijing, China). Patients with suspected AIP were enrolled between October 2018 and August 2023 and were randomly assigned to undergo tissue specimen collection using either a 19-gauge EUS-FNA needle or a 20-gauge EUS-FNB needle. The primary endpoint was the diagnostic accuracy against International Consensus Diagnostic Criteria, with secondary endpoints including histologic sensitivity, technical success rate, tissue adequacy, and adverse event rate. 46 patients were enrolled and 45 underwent EUS (FNB n = 23, FNA n = 22), amongst 42 had a final diagnosis of AIP. Diagnostic accuracy, as the primary endpoint, was 52.2

Pancreatic head-type autoimmune pancreatitis (PH-AIP) with elevated CA19-9 is sometimes difficult to distinguish from pancreatic head cancer (PHC) with elevated CA19-9. At times, IgG4 proves inadequate in offering assistance. The study aimed to elucidate the performance of CA19-9/DBil in distinguishing between the two conditions. This was a retrospective study. We collected serologic indicators from participants in PH-AIP and PHC Group. Three logistic regression equations were established ranging from non-adjustment (Model 1, only CA19-9/DBil included) to adjusting for sex, age, and CEA (Model 2 and Model 3) to explore the relationship between CA19-9/DBil and PH-AIP probability. ROC, Decision Curve Analysis (DCA), calibration curve were conducted. P for AUCs and net reclassification improvements (NRI) were computed to evaluate differences in discrimination and the improvement in risk reclassification between models. The study included 90 PHC and 35 PH-AIP patients, all with elevated CA19-9. The ORs for CA19-9/DBil in three models were similar (0.915 to 0.921). ROC revealed that Model 1 had an AUC of 0.772. The sensitivity, specificity, and accuracy at the best threshold were all > 0.7. Model 1, although simple, was not inferior in its discriminative ability compared to complex models: the difference in discrimination between Model 1 and each of two adjusted models was not statistically significant (P > 0.05, both AUC and NRI). Additionally, calibration curve and DCA suggested that Model 1 had good calibration and clinical utility. CA19-9/DBil exhibited promising diagnostic performance in differentiating between CA19-9-elevated PH-AIP and PHC.

Esophageal stricture is a common complication after esophageal endoscopic submucosal dissection (ESD). Pathological scars may predict stricture development, but clinical studies exploring their relationship are limited. This study aimed to investigate the link between concurrent pathological scarring and post-ESD esophageal stricture and develop a predictive risk model. This retrospective single-center study included patients who underwent ESD for superficial esophageal lesions (SELs) over the past decade. Data on demographics, endoscopy, pathology, and concurrent scarring were collected. Multivariate logistic regression identified risk factors, followed by validation using subgroup analysis and propensity score matching. A nomogram was developed and internally validated. Of 255 patients, 28 (11.0

Background: The unplanned repeated endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct stone (CBDS) remains unclear. Objectives: To identify risk factors of unplanned repeated ERCP and its impact on clinical outcomes. Design: Retrospective cohort study. Methods: Patients who underwent ERCP for CBDSs from January 2013 to October 2023 were consecutively reviewed. Risk factors for unplanned repeated ERCP within 1 month were evaluated using logistic regression. The impact of unplanned repeated ERCP on adverse events, including ampullary bleeding, CBDSs recurrence, and biliary infection, was explored. Results: A total of 1241 patients were included, of which 50 patients underwent unplanned repeated ERCP in 1 month primarily because of unrelieved biliary obstruction or cholangitis. The repeated ERCP group had higher proportions of irregular papilla (42.0% vs 21.7%, p < 0.001), stones locating in superior common bile duct (CBD; 18.0% vs 8.8%, p = 0.05), larger CBD diameter (median 1.2 vs 1.0 cm, p = 0.002), or larger CBDS diameter (median 1.0 vs 0.8 cm, p = 0.004) than the unrepeated group. In the multivariate analysis, irregular papilla (odds ratio (OR) 3.494, p = 0.024), post-ERCP fever (OR 7.532, p < 0.001), post-ERCP abdominal pain (OR 2.810, p = 0.05), post-/pre-ERCP total bilirubin levels ⩾1.2 times (OR 6.973, p = 0.007), and post-/pre-ERCP transaminase levels ⩾1.2 times (OR 3.944, p = 0.026) were independent risk factors for unplanned repeated ERCP. The incidence of adverse events in the long term was higher in the repeated group than the unrepeated group (12.0% vs 5.0%, p = 0.068). Unplanned repeated ERCP, although not an independent factor, is partially relevant with increased likelihood of long-term adverse events (univariate OR 2.570, p = 0.038). Conclusion: Papillary morphology, post-ERCP symptoms, and serum biochemical parameters may help predict the occurrence of unplanned repeated ERCP in patients with CBDS. Unplanned repeated ERCP does not have a significant impact on the long-term prognosis.

ObjectiveTo explore the application value of endoscopic ultrasound fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment ofpatients with pancreatic cancer combined with obstructive jaundice.MethodsClinical data of patients hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital who underwent ERCP biliary stent drainage for pancreatic cancer combined with obstructive jaundice from January 1, 2023 to February 26, 2024 were retrospectively collected. They were categorized into the fusion technology group and the simple ERCP group according to whether EUS-FNA was performed in the same endoscopic unit. The differences in pathologic diagnosis rate, ERCP drainage success rate, postoperative complication rate and patients' single hospitalization time were compared between the two groups.ResultsA total of 161 patients with pancreatic cancer combined with obstructive jaundice who underwent ERCP biliary stent drainage meeting the inclusion and exclusion criteria were enrolled, of which 80 were in the fusion technique group and 81 were in the simple ERCP group. The pathological diagnosis rate in the fusion technique group was higher than that in the simple ERCP group[92.50%(74/80) vs. 46.15%(12/26), P < 0.001], and the ERCP drainage success rate[82.50%(66/80) vs. 86.42%(70/81), P=0.360], the overall postoperative complication rate[5.00%(4/80) vs. 2.47%(2/81), P=0.443], and single hospitalization time[4 (4, 7)d vs. 5 (3, 9)d, P=0.397] were not statistically different from simple ERCP groups.ConclusionThe fusion of EUS-FNA and ERCP enhances the efficiency of diagnosis and treatment for pancreatic carcinoma, warranting widespread adoption and further research.

Introduction: Gallstones are one of the most common digestive diseases globally, with an estimated affected population of 15% in the United States. Our aim is to assess the current association between oral health and gallstones, exploring potential mediation factors. Methods: Self-reported gallstones were determined based on medical condition questionnaires. Dental status was assessed by dental professionals and oral health questionnaire. Mediation analysis was conducted for body mass index, blood glucose, triglycerides, and cholesterol, and the percentage of mediation effects was calculated. Results: We included 444 patients with gallstones and 3565 non-gallstone participants from National Health and Nutrition Examination Survey. After fully adjusting for all covariates, the prevalence of gallstones is higher when the number of missing teeth is at T3 compared to T1 (odds ratio [OR]: 1.93, confidence interval [CI]: 1.14 - 3.26, p = 0.02, p-trend = 0.01), and there was an inverted L-shaped association between missing teeth and gallstones, with an inflection point of 17. Bone loss around mouth was also associated with gallstones (OR: 1.78, 95% CI: 1.27 - 2.48, p = 0.002), but not root caries and gum disease. Mediation analysis identified blood glucose as a crucial mediator, with a mediation effect ratio of 4.91%. Conclusions: Appropriate lifestyle interventions for patients with missing teeth may help delay the onset of gallstones, such as healthy dietary habits, trace elements supplementing, and managing weight and blood sugar levels. Further exploration of the relationship between oral health and overall health contributes to disease prevention and comprehensive medical management.

Background The diagnosis of autoimmune pancreatitis (AIP) is multidisciplinary, with the histopathological diagnosis providing crucial information for distinguishing AIP from malignancies. Here we compared the diagnostic performance and sample adequacy of 19-gauge endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) needles with 20-gauge endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) needles in patients with suspected AIP. Methods Patients with suspected AIP were enrolled between October 2018 and August 2020 into a single-center, prospective, randomized controlled study conducted at a tertiary medical center in Beijing. Participants were randomly assigned to undergo tissue specimen collection using either a 19-gauge EUS-FNA needle or a 20-gauge EUS-FNB needle. The primary endpoint was the sensitivity of the two needle types for diagnosing AIP, with secondary endpoints including diagnostic sufficiency of tissue obtained, technical success rate, adverse event rate, and contribution of histologic findings to the AIP diagnosis according to International Consensus Diagnostic Criteria. Results Forty-five patients were enrolled. There was no significant difference in diagnostic efficacy between the 19-gauge FNA needle and the 20-gauge forward-beveled FNB needle for AIP. Both needle types showed similar sensitivity and overall accuracy in diagnosing benign disease, including AIP. The median tissue length was comparable between the two groups, and there was no significant difference in adverse events. Conclusions There is no difference in diagnostic efficacy or core tissue acquisition between 19-gauge FNA and 20-gauge forward-beveled FNB needles for patients with AIP. The 19-gauge FNA needle may serve as an alternative in centers where FNB needles are not available. Trial Registration ClinicalTrials.gov NCT03753815

A 49-year-old male was admitted because of watery diarrhea, acid reflux, and intermittent abdominal pain. The symptoms could be alleviated by regular uptake of proton-pump inhibitors. The endoscopic examination showed the thick folds of the gastric body. The gastrin level was elevated (420 pg/mL; normal range, 25–100 pg/mL). The computed tomography (CT) scan of the abdomen revealed a 1.7-cm soft-tissue mass with enhancement adjacent to the lesser curvature of the stomach and anterior to the pancreatic neck, which also showed a high uptake in the somatostatin receptor tomography (SRT) [Figure 1]. EUS could locate this lesion (contrast-enhanced EUS, Video 1), and fine-needle aspiration (FNA) was accomplished. The pathological finding of FNA was consistent with neuroendocrine tumor [Figure 2], while no submucosal lesion was seen in duodenum in both EUS scanning and esophagogastroduodenoscopy examination. The patient underwent laparoscopic lesser omentum mass resection. The pathological findings showed neuroendocrine tumor in lymph node (LN) [Figure 2], in which immunohistochemical staining showed chromogranin A (CgA) (+), synaptophysin (+), and Ki-67 (index 1%) [Figure 2]. The gastrin level rapidly decreased to normal (29 pg/mL) in 3 days postoperatively and remained normal in 1-month and 1-year follow-up. There was no recurrence of diarrhea after operation and PPI discontinuation. No new lesion was detected by CT and SRT in 1-year follow-up.Figure 1: Computed tomography and somatostatin receptor tomography. (a,b) abdominal contrast computed tomography demonstrating a 1.7-cm lesion (arrow) adjacent to the lesser curvature of the stomach (anterior to the pancreatic neck); (c) the high octreotide uptake of the same lesion in somatostatin receptor tomography, looking like the “sun” beside the pancreatic neckFigure 2: Pathology findings of lymph node gastrinoma. (a) The hematoxylin and eosin staining of EUS-FNA sample smear shows the small round cells, whose morphology is consistent with neuroendocrine tumor; (b) gross specimen of resected lymph node gastrinoma; (c and d) immunohistochemistry staining shows positivity of chromogranin A and synaptophysin; (e and f) shows the neuroendocrine tumor cells in the lymph nodeGastrinoma accounts for 70% of cases of pancreatic neuroendocrine tumors.[1] The majority of gastrinomas are sporadic, which usually occur in the “gastrinoma triangle” (which is composed of the porta hepatis, duodenal sweep, and pancreatic head);[2] ectopic gastrinomas are rare (<5%), which may grow in LN, liver, bile duct, and ovary.[3] Gastrin overproduction leads to oversecretion of stomach acid, causes multiple peptic ulceration, and deactivates pancreatic enzymes which result in fat malabsorption and diarrhea.[45] The fasting gastrin is the preferred biochemical diagnosis test, and an increase in gastrin levels >120 pg/mL over basal fasting levels is considered positive.[6] CT and magnetic resonance imaging (MRI) are thought to have high specificity (about 95%–100%); but the sensitivity of CT for smaller tumors or tumors outside the pancreas and liver is reduced, while MRI has an advantage in detecting liver metastases. SRT improved the higher sensitivity of tumor localization to 78%–88% than 25%–85% of CT and MRI.[7] EUS is more sensitive modality for detecting small intrapancreatic tumors, commonly used for screening multiple endocrine neoplasm type 1.[8] There is sufficient evidence that primary LN gastrinoma exists.[9] A study of 176 gastrinoma patients followed for 10 years revealed that primary LN gastrinoma was present in 10% of patients, which is not uncommon.[10] Pathological evidence for the presence of neuroendocrine cells in trigonal LNs in patients without gastrinoma supports the possibility of primary gastrinoma in LNs.[11] Tissue development studies suggest that pancreatic stem cells from the ventral buds disperse and merge into lymphoid tissue and duodenal wall during embryonic development.[12] However, there was no difference in clinical characteristics, number, and location of LNs between patients with primary and metastatic LNs gastrinoma.[13] The recommended diagnostic criteria may be used to distinguish between primary LN gastrinoma and LN metastases from unknown lesions of gastrinoma: Careful exploration without tumor in other sites during surgery, rapid normalization of the serum gastrin level after surgery, continuous normalization of serum gastrin, and the absence of disease during the postoperative follow-up period.[14] A long-term disease-free survival of more than 10 years with negative gastrin level as well as negative multiple imaging studies (CT, MRI, and SRT) argues for the likelihood that the LN gastrinoma was the primary.[10] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published, and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed. Financial support and sponsorship Beijing Science and Technology Program (Z181100001618013); Peking Union Medical College Education Reform Program (2019zlgc1006). Conflicts of interest Aiming Yang is an Editorial Board Member of the journal. The article was subject to the journal’s standard procedures, with peer review handled independently of this member and his research group. There are no other conflicts of interest.

Introduction: Early gastric cancer with current Helicobacter pylori infection (HpC-EGC) is common, but it is still unclear whether H. pylori eradication therapy (Hp-ET) or endoscopic submucosal dissection (ESD) should be performed first. We evaluated Hp-ETs short-term effects on horizontal boundary delineations of HpC-EGC in ESD. Methods: Prospectively enrolled HpC-EGC patients were randomly assigned to eradication or control groups. Operation scopes of HpC-EGC lesions were delineated with marking dots at 5 mm out of the endoscopic demarcation line by an independent endoscopist, unaware of eradication status, before formal circumferential incision. As representatives, precise delineation rate, the shortest distance of all marking dots to the pathological demarcation line in all slices of one intact resected specimen (Dmin), and negative marking dot specimen rate were examined. Results: Twenty-three HpC-EGC patients (25 lesions) were allocated to eradication group and 26 patients (27 lesions) were allocated to the control group with similar eradication success rates and all were differentiated type. With improving background mucosa inflammation after Hp-ET and similar gastritis-like epithelium rates, 10 lesions (40.0%) in the eradication group were of precise delineation compared to control group with 2 lesions (7.4%) (relative risk = 5.40, 95% CI 1.31–22.28). Dmin of eradication and control groups were 4.17 ± 2.52 mm and 2.67 ± 2.30 mm (p = 0.029), accompanied by 4 (14.8%) and none (0.0%) specimens that exhibited positive marking dots (p = 0.11), respectively. Conclusion: For HpC-EGC patients, administrating eradication medication before ESD is beneficial for the precise delineation of lesions and reducing the risk of positive horizontal resection margins.

This pilot study aimed to evaluate the efficacy and safety of domperidone for the treatment of Chinese patients with functional dyspepsia (FD) who were diagnosed according to the Rome IV criteria and to identify the FD subtypes that potentially responded better to domperidone. This multicenter prospective study was conducted in China from August 2018 to July 2020, consisting of a 1-week screening phase and a 2-week double-blind treatment phase. Participants were randomized to receive domperidone 10 mg or matching placebo tablets thrice daily for 14 days. The primary end-point was the overall treatment effect (OTE) response rate after 2-week therapy. Altogether 160 patients were included, with 80 patients in each group. The OTE response rate after 2-week therapy was significantly higher for domperidone compared with placebo (60.7% vs 46.0%; relative risk [RR] 1.318, 95% confidence interval [CI] 0.972–1.787). Moreover, the OTE response rate after 2-week domperidone or placebo treatment was 60.3% versus 54.9% for postprandial distress syndrome (PDS) (RR 1.098, 95% CI 0.750–1.607) and 60.6% versus 35.2% for overlapping PDS–epigastric pain syndrome (EPS) (RR 1.722, 95% CI 0.995–2.980). Adverse events were reported by seven patients in the domperidone group and 12 patients in the placebo group. None of the adverse events in the domperidone group were serious. Domperidone showed a positive pattern regarding OTE response rates after 2-week therapy compared to placebo in patients with FD, as well as in subtypes of PDS and overlapping PDS–EPS. No new safety issue was observed.

BackgroundEndoscopic ultrasound (EUS)-guided tissue acquisition (TA) by EUS-guided fine needle aspiration (FNA) or fine needle biopsy (FNB) is a standard diagnostic procedure for solid pancreatic lesions. Whether rapid on-site evaluation (ROSE) should be used to support EUS-TA remains controversial. Here we assessed the diagnostic performance of EUS-TA with or without self-ROSE for solid pancreatic masses.MethodsThree hundred and seventy EUS-TA cases with self-ROSE and 244 cases without ROSE were retrospectively enrolled between August 2018 and June 2022. All procedures including ROSE were performed by the attending endoscopist. Clinical data, EUS characteristics, and diagnostic performance for distinguishing benign from malignant solid pancreatic masses including accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were compared between groups.ResultsSelf-ROSE improved the diagnostic accuracy of solid pancreatic lesions by 16.7% in the EUS-TA group (p < 0.001) and by 18.9% in the EUS-FNA alone group (p < 0.001). Self-ROSE also improved the diagnostic sensitivity by 18.6% in the EUS-TA group (p < 0.001) and by 21.2% in the EUS-FNA alone group (p < 0.001). Improvements in the diagnostic accuracy by self-ROSE in the EUS-FNB group were not significant. 2.2 +/- 0.7, 2.4 +/- 0.9, 2.3 +/- 0.7, 2.5 +/- 0.9, 2.1 +/- 0.6, and 2.1 +/- 0.7 needle passes were required in the EUS-TA, EUS-FNA, and EUS-FNB with or without self-ROSE groups, respectively.ConclusionsSelf-ROSE significantly improved the accuracy and sensitivity of EUS-FNA alone and EUS-TA diagnosis of solid pancreatic lesions and helped to reduce needle passes during the procedure. Whether self-ROSE benefits EUS-FNB and whether EUS-FNB alone is comparable to EUS-FNA with self-ROSE require further clarification.

ObjectiveThis pilot study aimed to evaluate the efficacy and safety of domperidone for the treatment of Chinese patients with functional dyspepsia (FD) who were diagnosed according to the Rome IV criteria and to identify the FD subtypes that potentially responded better to domperidone.MethodsThis multicenter prospective study was conducted in China from August 2018 to July 2020, consisting of a 1-week screening phase and a 2-week double-blind treatment phase. Participants were randomized to receive domperidone 10 mg or matching placebo tablets thrice daily for 14 days. The primary end-point was the overall treatment effect (OTE) response rate after 2-week therapy.ResultsAltogether 160 patients were included, with 80 patients in each group. The OTE response rate after 2-week therapy was significantly higher for domperidone compared with placebo (60.7% vs 46.0%; relative risk [RR] 1.318, 95% confidence interval [CI] 0.972-1.787). Moreover, the OTE response rate after 2-week domperidone or placebo treatment was 60.3% versus 54.9% for postprandial distress syndrome (PDS) (RR 1.098, 95% CI 0.750-1.607) and 60.6% versus 35.2% for overlapping PDS-epigastric pain syndrome (EPS) (RR 1.722, 95% CI 0.995-2.980). Adverse events were reported by seven patients in the domperidone group and 12 patients in the placebo group. None of the adverse events in the domperidone group were serious.ConclusionDomperidone showed a positive pattern regarding OTE response rates after 2-week therapy compared to placebo in patients with FD, as well as in subtypes of PDS and overlapping PDS-EPS. No new safety issue was observed. This pilot study aimed to evaluate the safety and efficacy of domperidone in the treatment of Chinese patients with functional dyspepsia (FD) who were diagnosed according to the Rome IV criteria, including identification of FD subtypes that potentially respond better to domperidone. Among the 160 patients enrolled, domperidone showed a positive pattern regarding overall treatment effect (OTE) response rate after 2-week therapy compared to placebo in patients with FD as well as those with FD subtypes of postprandial distress syndrome (PDS) and overlapping PDS-epigastric pain syndrome (EPS). No new safety issues were observed.image

Background Pigment gallstones are not uncommon among patients with chronic haemolytic anaemia. But their clinical characteristics have not been described in detail and not been directly compared with the general gallstone population. Methods Patients at Peking Union Medical College Hospital with haemolytic anaemia and subsequent gallstones from January 2012 to December 2022 were included. Cases were matched (1:2) based on age, sex and location of stones to randomly select non-anaemia patients with gallstones (controls). Results Screening 899 cases of gallstones, we finally included 76 cases and 152 controls. Total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) for cases were 3.02 +/- 0.98 mmol/L, 0.89 +/- 0.30 mmol/L and 1.58 +/- 0.70 mmol/L, respectively, significantly lower than those in the control group (all p < 0.001). TC and HDL were both lower than the normal range, but triglyceride and LDL were within the normal range. Multiple stones were significantly more common for cases (n = 59, 78%) than for controls (n = 44, 29%, p < 0.001). The mean diameter of the maximal gallstone was 1.2 +/- 0.6 cm and 1.5 +/- 1.0 cm for cases and controls (p = 0.120), respectively. Stones in the elderly (p = 0.002 for univariate analysis, and 0.001 for multivariate analysis) and stones in the bile duct (p = 0.005 for univariate analysis, and 0.009 for multivariate analysis) were found to occur in a shorter period after anaemia. Conclusion The lipid profile of haemolytic anaemia with gallstones was distinct, low TC, low HDL, and increased-to-normal LDL, compared with the general gallstone population. Patients with haemolytic anaemia were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits. KEY MESSAGES Clinical characteristics of gallstones following chronic haemolytic anaemia were described and compared with the general gallstone population. The lipid profiles were distinctly different between the patients with gallstones following chronic haemolytic anaemia and the general gallstone population. Elder patients were complicated with gallstones in a shorter period after anaemia and thus were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits.