Nationwide epidemiological study of severe gallstone disease in Taiwan

Abstract

Background: Our study aimed to assess the nationwide trends in the incidence of severe gallstone disease in Taiwan among adults aged >or=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 >or=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 >or=60.

Figure 1

Age-standardized incident hospital admission rates of severe gallstone stone disease and related complications for men and women from 1997 to 2005.

Figure 2

Hospital admission incident trends of gallstone-related complications for age group (A) 20–39 (B) 40–59 (C) 60–79 (D) ≥80 during 1997–2005.

Figure 3

Age-standardized hospital admission rates of gallstone-related procedures for men and women from 1997 to 2005.

Figure 4

Trends in incident hospital admission rate of gallstone-related procedures for age group (A) 20–39 (B) 40–59 (C) 60–79 (D) ≥80 during 1997–2005.