Mortality and cardiovascular disease after cholecystectomy in type 2 diabetes: A nationwide longitudinal cohort study.

Background: The long-term effects of cholecystectomy on mortality and cardiovascular disease (CVD) in patients with diabetes have not been evaluated. In the present study, we investigated the longitudinal effects of cholecystectomy on mortality and CVD in a population-based cohort with type 2 diabetes (T2D).

Methods: In total, 2 216 930 national health examination participants with T2D, including 19 258 patients with cholecystectomy, were followed up for a median of 7.9 years. The adjusted hazard ratios (aHRs) were calculated for all-cause mortality and CVD (myocardial infarction or ischemic stroke) in the cholecystectomy group compared with the nonoperative controls.

Results: The cholecystectomy group had a significantly higher risk of mortality than controls (aHR 1.10, 95% confidence interval [CI]: 1.06-1.14), which was more pronounced in younger participants (aHR 1.67 [1.38-2.03], 1.22 [1.13-1.31], and 1.05 [1.00-1.10] for those aged <50, 50-64, and ≥65 years) and participants with less advanced diabetes treatment. The risk of CVD was increased with cholecystectomy only in those aged <50 years (aHR 1.24 [1.01-1.52]).

Conclusions: Cholecystectomy in patients with T2D is associated with an increased risk of all-cause mortality, particularly in younger patients without diabetes medication. Only patients aged <50 years have a higher risk of developing CVD after cholecystectomy.