Symptomatic Cholelithiasis Patients Have Increased Pancreatic Cancer Risk- A Population Based Study

Background :Pancreatic cancer is a fatal disease, andthe current risk factor survey is not suitable for sporadic pancreatic cancerthat lacks obvious family history orgenetic analysis data.The aim of the present study was to evaluate the roles of cholelithiasis and cholelithiasis treatmentson pancreatic cancer risk.Methods: Symptomatic adult patients with an index admission ofcholelithiasis diagnosis were selectedfrom one million random samples of National Health Insurance Research Database (NHIRD)obtained between January 2005 andDecember 2009. Exclusion criteria included pancreatic cancer, benign neoplasm or anomalies of the pancreas, orendoscopic sphincterotomy/endoscopic papillary balloon dilatation (ES/EPBD), cholecystectomy (CCY) before 2004. The control group was matched in a 1:1 ratio for sex, age,chronic pancreatitis and pancreatic cystic disease. The study group was divided into ES/EPBD, CCY, ES/EPBD&CCY, and no-intervention groupsfor subsequent pancreatic cancer evaluation.Results: Both the cholelithiasis group and the matched control group included 8,265 adult cases. The cholelithiasis group contained 86 (1.04%) cases of diagnosed pancreatic cancer and the control group contained8 (0.10%) cases (p<0.001). Exclusion of pancreatic cancer cases diagnosed in the first 6 months still resulted in asignificantly higher pancreatic cancer rate in the cholelithiasis group (0.22%) thanin the control group (0.05%)(p=0.003). The subsequent pancreatic cancer rates weresimilar,at0.17%, 0.11%, 0.26%, and 0.29%, in the ES/EPBD, CCY, ES/EPBD&CCY, and no-intervention groups, respectively.Conclusion:Symptomatic cholelithiasis is a risk factor for pancreatic cancer, and the risk is similar regardless of the intervention of cholelithiasis.Trial registration: This study was resisted on 23th August 2019 with registration number CS18136. The study design of this study is a retrospective database study.