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<p>Gastrectomy may induce physiological changes that increase susceptibility to alcohol-associated liver disease, even with low alcohol intake. This cohort study investigated the association between gastrectomy, alcohol consumption, and liver-related disease incidence using the Korean National Health Insurance Service database. We analyzed 57,893 patients diagnosed with gastric cancer between 2002 and 2015 who underwent either endoscopic resection (<i>n</i> = 22,078) or gastrectomy (<i>n</i> = 35,815). Over a median follow-up of 6.9 years, the gastrectomy group exhibited a significantly higher, dose-dependent risk of alcoholic liver disease (ALD; ICD-10 code K70), a major component of the alcohol-associated liver disease spectrum, compared to the endoscopic resection group (mild intake: adjusted hazard ratio [aHR] 1.58, 95% CI 1.26–1.97; moderate-to-severe: aHR 1.61, 95% CI 1.22–2.12). Similarly, the risk of cirrhosis was significantly elevated in the gastrectomy group with moderate-to-severe alcohol intake (aHR 1.93, 95% CI 1.11–3.38), while no significant differences were observed in hepatocellular carcinoma incidence. These findings demonstrate that gastrectomy is associated with a heightened risk of ALD, even at low levels of alcohol consumption. Our findings suggest that careful monitoring of alcohol consumption and appropriate counseling may be warranted in patients following gastrectomy.</p>

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Impact of gastrectomy on the risk of alcohol-associated liver disease in patients with gastric cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月17日

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  • Sang Yi Moon,
  • Yang Hyun Baek,
  • Dongwoo Kang,
  • Jungkuk Lee,
  • Yeo Wool Kang,
  • Minkook Son,
  • Hongqun Liu,
  • Samuel S. Lee,
  • Junho Park

摘要

Gastrectomy may induce physiological changes that increase susceptibility to alcohol-associated liver disease, even with low alcohol intake. This cohort study investigated the association between gastrectomy, alcohol consumption, and liver-related disease incidence using the Korean National Health Insurance Service database. We analyzed 57,893 patients diagnosed with gastric cancer between 2002 and 2015 who underwent either endoscopic resection (n = 22,078) or gastrectomy (n = 35,815). Over a median follow-up of 6.9 years, the gastrectomy group exhibited a significantly higher, dose-dependent risk of alcoholic liver disease (ALD; ICD-10 code K70), a major component of the alcohol-associated liver disease spectrum, compared to the endoscopic resection group (mild intake: adjusted hazard ratio [aHR] 1.58, 95% CI 1.26–1.97; moderate-to-severe: aHR 1.61, 95% CI 1.22–2.12). Similarly, the risk of cirrhosis was significantly elevated in the gastrectomy group with moderate-to-severe alcohol intake (aHR 1.93, 95% CI 1.11–3.38), while no significant differences were observed in hepatocellular carcinoma incidence. These findings demonstrate that gastrectomy is associated with a heightened risk of ALD, even at low levels of alcohol consumption. Our findings suggest that careful monitoring of alcohol consumption and appropriate counseling may be warranted in patients following gastrectomy.