Endoscopic sphincterotomy and risk of cholangiocarcinoma: a population-based cohort study in Finland and Sweden

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dc.contributor University of Helsinki, Clinicum en
dc.contributor.author Strömberg, Cecilia
dc.contributor.author Böckelman, Camilla
dc.contributor.author Song, Huan
dc.contributor.author Ye, Weimin
dc.contributor.author Pukkala, Eero
dc.contributor.author Haglund, Caj
dc.contributor.author Nilsson, Magnus
dc.date.accessioned 2017-01-11T14:21:01Z
dc.date.available 2017-01-11T14:21:01Z
dc.date.issued 2016-10
dc.identifier.citation Strömberg , C , Böckelman , C , Song , H , Ye , W , Pukkala , E , Haglund , C & Nilsson , M 2016 , ' Endoscopic sphincterotomy and risk of cholangiocarcinoma: a population-based cohort study in Finland and Sweden ' , Endoscopy International Open , vol. 4 , no. 10 , pp. E1096-E1100 . https://doi.org/10.1055/s-0042-114982 en
dc.identifier.issn 2364-3722
dc.identifier.other PURE: 77059313
dc.identifier.other PURE UUID: bb60f345-8cd0-4bd5-9c59-9b761634f4ba
dc.identifier.other WOS: 000386313200014
dc.identifier.uri http://hdl.handle.net/10138/173249
dc.description.abstract Background and study aims: Elevated long-term risk of cholangiocarcinoma is reported after endoscopic sphincterotomy (ES), but in a previous study we found a trend towards a decreased risk. The aim of this study was to evaluate the association in a larger cohort with a longer follow-up. Patients and methods: Data concerning all patients having had an inpatient endoscopic retrograde cholangiopancreatography (ERCP) were collected from the hospital discharge registries of Finland and Sweden. Incident cases of malignancy were identified through linkage to the nationwide Cancer Registries. Patients with a diagnosis of malignancy, before or within 2 years of the ERCP, were excluded. The cohorts were followed until a diagnosis of malignancy, death or emigration, or end of follow-up (end of 2010). The relative risk of malignancy was calculated as standardized incidence ratio (SIR) compared with the general population, inherently adjusting for age, gender, and calendar year of follow-up. Results: A total of 69 925 patients undergoing ERCP from 1976 through 2008 were included in the pooled cohort. ES was performed in 40 193 subjects. The risk of malignancy was elevated in the total cohort (SIR = 2.3; 95 % confidence interval [CI] 2.1 - 2.5) irrespective of whether ES was performed or not. The SIRs diminished with duration of follow-up. Conclusions: We found an elevated risk of malignancy both in the bile ducts alone and in the bile ducts, liver or pancreas together, after ERCP. The risk was the same, regardless of whether ES had been performed or not, so ES was unlikely to be the cause, and a common carcinogenic exposure previous to the ERCP procedure, possibly ductal gallstone disease, was more likely. fi
dc.format.extent 5
dc.language.iso eng
dc.relation.ispartof Endoscopy International Open
dc.rights en
dc.subject 3121 General medicine, internal medicine and other clinical medicine en
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology en
dc.title Endoscopic sphincterotomy and risk of cholangiocarcinoma: a population-based cohort study in Finland and Sweden en
dc.type Article
dc.description.version Peer reviewed
dc.identifier.doi https://doi.org/10.1055/s-0042-114982
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion
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