Nationwide epidemiological study of severe gallstone disease in Taiwan

BMC Gastroenterol. 2009 Aug 22;9:63. doi: 10.1186/1471-230X-9-63.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cholangitis / epidemiology
  • Cholecystitis, Acute / epidemiology
  • Female
  • Gallstones / complications
  • Gallstones / epidemiology*
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pancreatitis / epidemiology
  • Retrospective Studies
  • Severity of Illness Index*
  • Taiwan / epidemiology