Kolorektal neoplazm gelişiminde endoskopik biliyer sfinkterotomi'nin rolü

Objective: Colorectal Cancer (CRC) is the third malignancy worldwide in terms of diagnosis risks and second in terms of death. Although various factors are emphasized in the etiopathogenesis of the disease, it is known that the vast majority of cases arise from adenomatous polyps. Endoscopic biliary sphincterotomy (EBS) is a widely and effectively used treatment method in the treatment of pancreaticobiliary disorders. There are studies in the literature supporting that cholecystectomy is a risk factor for the development of CRC and colorectal adenoma. In this study, it was aimed to examine whether continuous bile flow after EBS with a similar mechanism to cholecystectomy is a risk factor for CRC and adenomas. Patients and Methods: The study included 96 patients who underwent colonoscopy between January 2007 and December 2022 in Ondokuz Mayıs University Medical Faculty Hospital Gastroenterology Department, after EBS and one year or more time lamp, and had similar comprehensiveness without a history of cholecystectomy, ERCP, and ASA use. A total of 186 people were included in the control group, which included 90 people (age range), gender, additional comorbid diseases). Gender, age, body mass index, smoking and alcohol use of the patients, ht, dm, cad, history of CRC in a first degree relative, history of cholecystectomy, indication for ERCP, whether stones were detected in ERCP, time until colonoscopy after ERCP, colonoscopy indication and the histopathological subtype and localization data of the detected neoplastic formations were recorded. Results: The female/male ratio of the patients included in the study was 43/53, and the mean age was 69±13 years. Similarly, the female-male ratio of the patients in the control group was 47/43, and the mean age was 67±12 years. There was no statistically significant relationship between gender, smoking, alcohol, ASA use history, HT, CAD and EBS and colorectal neoplasia between the groups. Age (p=0.047), BMI (p<0.01), history of CRC in a first-degree relative (p=0.01), history of cholecystectomy (p<0.01), and time elapsed after EBS (p=0.14) and colorectal neoplasia was found to be statistically significant. Conclusion: In our study, a significant relationship was found between age, high BMI, positive family history of CRC in a first-degree relative, and cholecystectomy and colorectal neoplasia. However, no statistically significant relationship was found between EBS and colorectal neoplasms. There is a need for controlled studies with more cases and long-term follow-up on this subject.