Association of Gallstone Disease and Cholecystectomy With Duodenal Polyps and Barrett's Oesophagus

BACKGROUND AND AIM: We hypothesized that duodenal polyps (DP) and Barrett's oesophagus (BE) coincide in the same patients and that biliary disease, such as cholelithiasis (GS) or cholecystectomy (CCx), increases the risk for both DP and BE. We used a case-control study design to test our hypothesis. METHODS: Using the healthcare records of the University of Pennsylvania Health System (UPHS), we compared the frequency of GS or CCx in patients with DP or BE with their corresponding frequencies in a control population of patients without DP or BE. Odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated using multivariate logistic regression analysis. RESULTS: The UPHS electronic database from 1/2016 until 3/2026 contained a total of 175,808 unique patients with EGD or colonoscopy, of whom 3632 underwent a CCx, 11,122 had GS, 669 had DP and 4965 had BE. The OR (95% CI) values for the association between BE and DP were 4.64 (3.63-5.86). The OR values for the GS association with DP were 2.23 (1.78-2.76) and for the CCx association with DP 2.26 (1.54-3.20). The OR values for the association between GS and BE were 1.46 (1.32-1.60) and for the CCx association with BE 1.57 (1.33-1.84). CONCLUSIONS: Cholelithiasis and cholecystectomy are associated with an increased risk for duodenal polyps and Barrett's oesophagus. In support of this finding, duodenal polyps and Barrett's oesophagus are also found to coincide in the same patients.