{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T18:38:33Z","timestamp":1776451113941,"version":"3.51.2"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T00:00:00Z","timestamp":1587600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The objective of this study is to assess the relationship between gallstones and venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), and the risk of VTE after cholecystectomy for gallstones. This nationwide population-based cohort study retrieved the hospitalization database from the Longitudinal Health Insurance Research Database (LHID2000), a database belonging to the National Health Insurance (NHI) program of Taiwan. A total of 345,793 patients aged \u2265 18 years with gallstones diagnosed between 2000 and 2010 were identified as the study cohort. The beneficiaries without gallstones were randomly selected as the control cohort by propensity score matching with the study cohort at a 1:1 ratio based on age, sex, urbanization, occupation, comorbidities, and year of the index date. We compared the risk of VTE between both cohorts and measured the risk differences of VTE between the gallstones patients with (n = 194,187) and without cholecystectomy (n = 151,606). Each patient was examined from the index date until the occurrence of DVT or PE, death or withdrawal from the NHI program, or the end of 2011. The incidence rate of DVT was 7.94\/10,000 person-years for the non-gallstones cohort and 9.64\/10,000 person-years for the gallstones cohort (hazard ratio (HR) = 1.35, 95% confidence interval (CI) = 1.25\u20131.47), respectively (p &lt; 0.001). The incidence rate of PE was 3.92\/10,000 person-years for the non-gallstones cohort and 4.65\/10,000 person-years for the gallstones cohort (HR = 1.35, 95% CI = 1.20\u20131.53), respectively (p &lt; 0.001). The cumulative incidence of DVT (6.54\/10,000 person-years vs 14.6\/10,000 person-years, adjusted hazard ratio (aHR) = 0.60, 95% CI = 0.54\u20130.67) and PE (3.29\/10,000 person-years vs 6.84\/10,000 person-years, aHR = 0.67, 95% CI = 0.58\u20130.77) for gallstones patients was lower in the cholecystectomy cohort than that in the non-cholecystectomy cohort after adjustment for age, sex, urbanization level, occupation, frequency of medical visits, history of pregnancy, and comorbidities (log-rank test, p &lt; 0.001). Our findings indicate that the risk of DVT or PE in patients with gallstones was greater than those without gallstones. However, the risk of DVT and PE in the patients with gallstones would decrease after cholecystectomy. This area of research needs more studies to ascertain the pathogenesis for the contribution of gallstones to the development of VTE and the protective mechanisms of cholecystectomy against the development of VTE.<\/jats:p>","DOI":"10.3390\/ijerph17082930","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T11:42:14Z","timestamp":1587728534000},"page":"2930","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Risk of Venous Thromboembolism in Patients with Gallstones"],"prefix":"10.3390","volume":"17","author":[{"given":"Chien-Hua","family":"Chen","sequence":"first","affiliation":[{"name":"Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang Township, Changhua County 505, Taiwan"},{"name":"Department of Food Science and Technology, Hungkuang University, Taichung 433, Taiwan"},{"name":"Chung Chou University of Science and Technology, Yuanlin Township, Changhua County 510, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"College of Medicine, China Medical University, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6368-3676","authenticated-orcid":false,"given":"Chia-Hung","family":"Kao","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan"},{"name":"Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3060","DOI":"10.1016\/S0140-6736(16)30514-1","article-title":"Deep vein thrombosis and pulmonary embolism","volume":"388","author":"Biller","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1001\/archinte.1991.00400050081016","article-title":"A population-based prospective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. 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