Risk for Choledocholithiasis Higher in Older Adult Patients With Cholangiocarcinoma

Choledocholithiasis, or common bile duct stones, is linked to the occurrence of cholangiocarcinoma (CCA), but the connection has not been sufficiently understood. A recent cohort study published in BMC Gastroenterology sought to evaluate the correlation between this condition and CCA.

The study gathered data from patients diagnosed with CCA between 2008 and 2009 in South Korea from the Health Insurance Review and Assessment database. Patients were stratified by age and grouped based on the presence of extrahepatic CCA (ECA) or intrahepatic CCA (ICA).

CCA incidence between patients with choledocholithiasis and the general population was compared by determining the standardized incidence ratio (SIR). A total of 20,808 patients were enrolled in the study. With a 10-year follow-up period, CCA was seen in 548 patients (2.64%), with 238 ECA cases (1.14%) and 310 ICA cases (1.48%).

In patients with ECA, the SIR was 25.23 (95% CI: 21.98–28.85), while in patients with ICA, it was 24.64 (95% CI: 21.87–27.73). After excluding cases within the first 2 years from the index date, statistical significance remained.

In patients with ECA, SIRs peaked when patients were diagnosed with choledocholithiasis from 70 to 79 years old, (SIR 16.61, 95% CI: 11.83–22.69) and from 60 to 69 years old(SIR 29.27, 95% CI: 23.53–36.03) for patients with ICA.

This study demonstrates that the correlation between choledocholithiasis and CCA is particularly high in patients in their 70s for those with ECA, and in patients in their 60s with ICA, but causation could not be determined.