Association of Cholecystectomy with Short-term and Long-term Risks of Depression and Suicide

Abstract Background: This study explores the relationship between cholecystectomy and short- and long-term depression and suicide risk in Korean adults. Method: A retrospective cohort study used data from the National Health Insurance Service of Korea (2002-2019). A total of 6,688 cholecystectomy patients were matched with 66,880 individuals without a history of cholecystectomy for suicide analysis, and 6,694 cholecystectomy patients were matched with 66,940 individuals for depression analysis. The non-cholecystectomy group was created by matching the experimental group at a 1 to 10 ratio for sex and age. The incidence of depression and suicide was followed from the day of cholecystectomy to December 31, 2019. Multivariable Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results: Short-term depression risk within 3 years of cholecystectomy was significantly elevated (aHR 1.37 [95% CI 1.19-1.58]), but the long-term depression risk over 3 years was not significantly greater (aHR 1.09 [95% CI 0.98-1.22]). There was no significant association between cholecystectomy and suicide risk during any period. Conclusions: Cholecystectomy correlated with a higher risk of short-term depression, underscoring the importance of close monitoring and support postoperatively. However, no such association was observed with long-term depression or suicide.