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Previous studies suggested an increase in gallstone rates and cholecystectomies related to urbanization and the adoption of Western lifestyle habits. This study examined cholecystectomy rates for gallstone disease in South Africa (SA). An audit of cholecystectomies in SA was done by reviewing gallbladder specimens processed by the SA National Health Laboratory Service (NHLS) from 2004 and 2014. Urbanization rates were obtained from Statistics South Africa and BMI data from previously published studies. Fisher\u2019s exact test, <jats:italic>t<\/jats:italic>\u00a0test\u2019s and Pearson\u2019s R were used for comparisons; cholecystectomy rates were calculated per 100,000 population. 33,467 cholecystectomy specimens were analysed. There was a 92% absolute increase in cholecystectomies during the study period (Pearson r 0.94; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) with the overall cholecystectomy rate increasing by 65% from 8.36 to 13.81 per 100,000 population. The data was divided into two equal periods and compared. During the second\u00a0period there was\u00a0a 28.8% increase in\u00a0the number cholecystectomies and patients were significantly younger (46.9 vs 48.2\u00a0years; <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.0001). The Northern Cape was the only province to show a decline in the cholecystectomy rate in\u00a0this period and was also the only province to record a decline in urbanization. Population based studies in SA demonstrate increases in BMI and an association with increased urbanization. This nationwide African study demonstrates a sustained increase in cholecystectomies for gallstone disease. Increases in BMI and urbanization may be responsible for this trend.<\/jats:p>","DOI":"10.1038\/s41598-020-69812-3","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T10:05:13Z","timestamp":1597140313000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Increases in cholecystectomy for gallstone related disease in South Africa"],"prefix":"10.1038","volume":"10","author":[{"given":"Zafar Ahmed","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Uzayr","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Brand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"69812_CR1","doi-asserted-by":"publisher","first-page":"172","DOI":"10.5009\/gnl.2012.6.2.172","volume":"6","author":"LM Stinton","year":"2012","unstructured":"Stinton, L. 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