Open Access Research article

Nationwide epidemiological study of severe gallstone disease in Taiwan

John Huang1, Chia-Hsuin Chang2, Juin-Ling Wang3, Hsu-Ko Kuo2, Jou-Wei Lin4, Wen-Yi Shau5* and Po-Huang Lee13*

Author Affiliations

1 Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, Republic of China

2 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China

3 E-Da Hospital, I-Sho University, Kaohsiung County, Taiwan, Republic of China

4 Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Douliou City, Taiwan, Republic of China

5 Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan, Republic of China

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BMC Gastroenterology 2009, 9:63  doi:10.1186/1471-230X-9-63

Published: 22 August 2009

Abstract

Background

Our study aimed to assess the nationwide trends in the incidence of severe gallstone disease in Taiwan among adults aged ≥20.

Methods

A retrospective longitudinal study was conducted using Taiwan National Health Insurance Research Database collected during 1997–2005. Patients with incident severe gallstone disease (acute cholecystitis, biliary pancreatitis, acute cholangitis) and gallstone-related procedures (elective and non-elective cholecystectomy, endoscopic retrograde cholangiopancreatography [ERCP]) that led to hospital admission were identified using ICD-9-CM diagnostic and procedure codes. Annual incidence rates of gallstone-related complications and procedures were calculated and their 95% confidence intervals (CI) were estimated assuming a Poisson distribution.

Results

The hospital admission rate for severe gallstone disease increased with advancing age and the age-standardized rate (95% CI) per 1000 population was 0.60 (0.59–0.60) for men and 0.59 (0.59–0.60) for women. Men had a higher rate of acute cholecystitis, probably due to the substantially lower rate of elective cholecystectomy among men than women. For those aged 20–39, hospital admissions for all gallstone-related complications and procedures increased significantly. For those aged ≥60, incidences of biliary pancreatitis, acute cholangitis, and hospital admission for gallstone receiving ERCP increased significantly without substantial change in the incidence of acute cholecystitis and despite a decreased rate of elective cholecystectomy.

Conclusion

This population-based study found a substantial increase in the rate of admission for severe gallstone disease among those aged 20–39. Concurrently, the incidences of biliary pancreatitis and acute cholangitis have risen among those aged ≥60.