Incisional hernias following gallstone surgery. A population-based study

Abstract

Background: The aim of this study was to determine the incidence of incisional hernia (IH) in a population-based cohort following gallstone surgery and to identify associated risk factors.

Methods: All cholecystectomies registered in the Swedish register for cholecystectomy and ERCP from 2006 to 2014 were identified. Data regarding post-procedural development of IH was obtained from the National Patient Register.

Results: A total of 81 964 cholecystectomies were identified. A laparoscopic, open, and minilaparotomy technique was used in 70 031, 10 379 and 1554 procedures, respectively. The five-year cumulative incidence of IH was 1.04 per cent in the laparoscopic group, 3.37 per cent in the open group, and 2.11 per cent in the minilaparotomy group. Obesity (hazard ratio (HR) 4.11, 95 per cent confidence interval [CI] 3.37 to 5.01), open surgical technique (HR 2.97, CI 2.57 to 3.42), liver cirrhosis (HR 2.95, CI 1.58 to 5.51), chronic kidney disease (HR 1.95, CI 1.19 to 3.21), minilaparotomy (HR 1.79, CI 1.23 to 2.60), age > median (HR 1.43, CI 1.25 to 1.65), and chronic pulmonary disease (HR 1.28, CI 1.05 to 1.57) were found to significantly predict the development of IH.

Conclusion: Laparoscopic cholecystectomy comes with a lower risk of IH compared to open techniques.