Cholecystectomy Linked to Lower Stroke Risk in Gallstone Disease

By Anne Harding

June 20, 2019

NEW YORK (Reuters Health) - Cholecystectomy is associated with a reduced risk of stroke, according to a new retrospective cohort study.

Based on the findings, physicians should advise their gallstone patients to take preventive measures against stroke, especially if they are at high risk, Dr. Yeh Yung-Hsiang of Show Chwan Memorial Hospital in Changhua, Taiwan, one of the study's authors, told Reuters Health by email.

Previous studies have found an association between gallstone disease and cardiovascular disease and death, as well as stroke, Dr. Yung-Hsiang and colleagues note in the Journal of Gastroenterology and Hepatology, online June 5.

They compared 155,356 gallstone patients who underwent cholecystectomy and 155,356 patients with gallstones who did not have their gallbladder removed.

From 2000-2012, 19,096 of patients without cholecystectomy (17.8/1,000 person-years) and 11,913 with cholecystectomy (10.6/1,000 person years) had a stroke. The risk was significantly decreased with cholecystectomy for all strokes (hazard ratio, 0.60), ischemic stroke (HR, 0.60) and hemorrhagic stroke (HR, 0.55).

Stroke risk was significantly lower for both asymptomatic and symptomatic gallstone patients after cholecystectomy, compared to asymptomatic patients who did not have their gallbladder removed.

"Physicians should make complete evaluation of underlying cerebrovascular risk factors for patients with gallstone disease," Dr. Yung-Hsiang told Reuters Health.

"Gallstones can lead to an inflammatory condition characterized by bile retention in the gallbladder," the researcher added. "The acute or chronic inflammation plays a crucial role in vascular events. So we assume that cholecystectomy could reduce stroke risk by eliminating (the) inflammatory mechanism. Still further studies need to be conducted to answer these questions."

The researchers also plan to investigate the effects of cholecystectomy in other diseases.


J Gastroenterol Hepatol 2019.