Surreal illustration of digestive tract representing Crohn's disease and gallbladder risks.

Cholecystectomy After Ileal Resection in Crohn's Disease: What's the Real Risk?

Reese Marlowe in Health & Wellness July 2025 • 4 min read.

"A long-term study reveals the true likelihood of needing gallbladder removal and who is most at risk."

If you have Crohn's disease and have undergone or are considering ileal resection (IR), you might be wondering about the risk of developing gallstones and needing your gallbladder removed (cholecystectomy). While it's known that Crohn's patients, especially those with ileal involvement, have a higher risk of gallstone disease, the actual likelihood of requiring surgery and the factors that increase this risk haven't been clearly defined.

A recent long-term nationwide study in the Netherlands aimed to shed light on this issue. Researchers followed a large group of Crohn's disease patients who had undergone ileal resection to determine the incidence, cumulative risk, and relative risk of cholecystectomy, as well as identify any associated risk factors.

This article breaks down the findings of this study, providing you with a clearer understanding of the real risk of cholecystectomy after ileal resection, helping you make informed decisions about your health and treatment.

The Real Risk: Cholecystectomy After Ileal Resection

Surreal illustration of digestive tract representing Crohn's disease and gallbladder risks.

The study followed 8302 CD patients after their first ileal resection, and during a median follow-up of nearly 12 years, the incidence rate of cholecystectomy was 5.2 per 1000 persons per year. This means that, on average, about 0.5% of patients had a cholecystectomy within one year after IR, 2.4% within 5 years, 4.6% within 10 years, and 10.3% after 20 years.

While these numbers are higher than in the general population, the overall risk remains relatively low. The study also identified several factors that can increase the risk of cholecystectomy after ileal resection:

Female Sex: Women were almost twice as likely to undergo cholecystectomy compared to men.
Later Calendar Year of First IR: Patients who had their first ileal resection in more recent years had a higher risk of cholecystectomy. This could be due to increased awareness and diagnosis of gallstone disease or changes in surgical practices.
Ileal Re-resection: Patients who required a second ileal resection during the follow-up period also had a slightly increased risk of cholecystectomy.

Compared to the general population, the study found that cholecystectomy rates in CD patients after IR were significantly higher, particularly in recent years. In 2015, the relative incidence ratio was 3.13, meaning that CD patients after IR were more than three times as likely to undergo cholecystectomy as the general population.

What Does This Mean for You?

The study's findings suggest that while the risk of cholecystectomy is increased in CD patients following ileal resection, it remains relatively low overall. This indicates that routine prophylactic measures, such as synchronous cholecystectomy (removing the gallbladder at the time of ileal resection), are likely unwarranted.

However, if you are a female CD patient who has undergone ileal resection, especially if you require further surgery on your ileum, it's essential to be aware of the increased risk and discuss any symptoms with your doctor promptly.

Ultimately, this study provides valuable data for both patients and clinicians, allowing for more informed decision-making regarding the management of gallstone disease in the context of Crohn's disease and ileal resection.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s11605-018-4028-y, Alternate LINK

Title: Cholecystectomy Risk In Crohn’S Disease Patients After Ileal Resection: A Long-Term Nationwide Cohort Study

Subject: Gastroenterology

Journal: Journal of Gastrointestinal Surgery

Publisher: Springer Science and Business Media LLC

Authors: Jorn C. Goet, Evelien M. J. Beelen, Katharina E. Biermann, Annette H. Gijsbers, W. Rudolph Schouten, C. Janneke Van Der Woude, Annemarie C. De Vries

Published: 2018-11-08

Everything You Need To Know

What are the chances of needing a cholecystectomy after an ileal resection?

The study determined that after ileal resection (IR), the incidence rate of cholecystectomy was 5.2 per 1000 persons per year. This means about 0.5% of patients had a cholecystectomy within one year after IR, 2.4% within 5 years, 4.6% within 10 years, and 10.3% after 20 years. While this risk is higher than the general population, it's still relatively low. This data is crucial for understanding the likelihood of needing gallbladder removal after ileal resection.

What increases the risk of cholecystectomy after ileal resection?

The factors that can increase the risk of cholecystectomy after ileal resection are female sex, later calendar year of the first IR, and needing another ileal re-resection. Women were almost twice as likely to undergo cholecystectomy. Patients who had their first ileal resection in more recent years had a higher risk. Patients who required a second ileal resection during the follow-up period also had a slightly increased risk. Knowing these factors can help patients and doctors make informed decisions and possibly take preventative measures.

What is a cholecystectomy and why is it relevant here?

The term 'cholecystectomy' refers to the surgical removal of the gallbladder. It's important in this context because it's a common concern for individuals with Crohn's disease who have undergone ileal resection (IR). The study investigated the actual risk of cholecystectomy, as patients with Crohn's disease, especially those with ileal involvement, have a higher risk of gallstone disease which can lead to cholecystectomy.

What does the study's conclusion mean for people with Crohn's disease?

The findings suggest the risk of cholecystectomy is increased in Crohn's disease patients following ileal resection, but it remains relatively low overall. This means routine prophylactic measures, like removing the gallbladder at the time of ileal resection, are likely not necessary for everyone. The implications are that patients and their doctors can use this information to make more informed decisions about the best course of action, rather than assuming every patient needs preventative surgery.

How do cholecystectomy rates compare between Crohn's disease patients after ileal resection and the general population?

The study's findings showed that cholecystectomy rates in Crohn's disease patients after ileal resection (IR) were significantly higher compared to the general population, especially in recent years. In 2015, the relative incidence ratio was 3.13, meaning patients were more than three times as likely to undergo cholecystectomy. This suggests that there may be an increased awareness and diagnosis of gallstone disease, or changes in surgical practices. It underscores the importance of monitoring and potential interventions for those with Crohn's disease who have had IR.