Cholecystectomy, a routine surgery for gallbladder disease, has established short-term advantages. Its long-term influence on death and cardiovascular disease, particularly among patients with diabetes, is less well understood. Considering the metabolic and inflammatory remodeling that occurs in response to removal of the gallbladder, investigators sought to establish its effect on long-term health outcomes among patients with T2D.
2,216,930 patients with T2D who underwent a national health examination were included in this study. Among them, 19,258 patients had undergone cholecystectomy. Participants were followed up for a median of 7.9 years. Researchers estimated adjusted hazard ratios (aHRs) to contrast all-cause mortality and CVD risk (myocardial infarction or ischemic stroke) in patients who had undergone cholecystectomy versus those who had not.
Key Findings
• The cholecystectomy group presented a 10% increased risk of mortality when compared to the nonoperative group (aHR 1.10, 95% CI: 1.06–1.14).
The greater risk of increased mortality was seen in younger individuals:
• Aged <50 years: aHR 1.67 (95% CI: 1.38–2.03)
• Aged 50–64 years: aHR 1.22 (95% CI: 1.13–1.31)
• Aged ≥65 years: aHR 1.05 (95% CI: 1.00–1.10)
• Individuals with less advanced treatment of diabetes were more susceptible to increased mortality following cholecystectomy.
• The hazard of CVD (myocardial infarction or ischemic stroke) was increased only in patients <50 years old (aHR 1.24, 95% CI: 1.01–1.52).
Cholecystectomy in T2D patients is linked to increased all-cause mortality, with younger patients and those not on diabetes medication being most vulnerable. Younger patients (<50 years) are also at greater risk of cardiovascular disease after surgery. These observations underscore the necessity for a more individualized strategy in assessing the risks and benefits of gallbladder removal in diabetic patients.
Reference:
Jung HN, Heo JH, Roh E, Han KD, Kang JG, Lee SJ, Ihm SH. Mortality and cardiovascular disease after cholecystectomy in type 2 diabetes: A nationwide longitudinal cohort study. J Hepatobiliary Pancreat Sci. 2025 Mar 3. doi: 10.1002/jhbp.12109. Epub ahead of print. PMID: 40033631.
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