# The Natural History of Overall Mortality with Diagnosed Symptomatic Gallstone Disease in the United States: A Sequential Mixed-methods Study Evaluating Emergency, Non-emergency, and No Cholecystectomy

> **NIH NIH K23** · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · 2024 · $228,679

## Abstract

Project Abstract
Surgery is often indicated when asymptomatic gallstone disease, with a prevalence as high as 20% in the US
population, becomes symptomatic; this occurs when gallstones block the digestive drainage of the gallbladder,
pancreas, liver, or intestine. Cholecystectomy, occurring in a million people in the US annually, is the surgical
removal of the gallbladder to treat this diagnosed symptomatic gallstone disease (dSGD). Whether patients have
a more morbid and costly emergency rather than a non-emergency cholecystectomy, may depend on many
factors which are largely unknown. However, since emergency cholecystectomy has been suggested to possibly
have 5 to 10x the mortality elective cholecystectomy has, if gallstone disease could be avoided completely via
high-quality prevention and non-surgical therapy, or when surgery is indicated it could be elective rather than an
emergency, overall mortality from this extremely common condition might be reduced. The objective of this K23
is to start population-based research on disease requiring emergency surgery, currently representing over two-
thirds of healthcare delivery in US hospitals and alarmingly over half of total mortality and cost. This will begin
with a study of the frequency of, and mortality from, emergency cholecystectomy, informed by the overall
population experience with dSGD. The main hypothesis of this study is emergency has higher mortality than
non-emergency cholecystectomy; if the natural history of dSGD were shifted from emergency to non-emergency
cholecystectomy this leads to a decrease in the overall mortality rate with dSGD. The goal this program of
research begins will be to provide population-based data to decrease less safe emergency surgery, moving
toward safer non-emergency surgery or non-surgical care, decreasing the overall US mortality of dSGD in the
process. The proposed study fits well with the candidate’s career development goals and 4-year training and
mentoring program to evolve into an independent clinical epidemiologist studying digestive diseases requiring
emergency surgery. The candidate is pivoting from a primarily clinical career to a research career. He has strong
experience in emergency surgery and public health, and seeks training in rigorous clinical epidemiology methods,
claims data research, deeper biostatistical expertise, new skills to collaborate on mixed-methods patient-oriented
research, and a mentored transition to designing new etiologic studies of his own. The mentorship team consists
of recognized experts in clinical epidemiology research and training, gallstone epidemiology, inferential
biostatistics, prevention and qualitative methods, and emergency surgery, who will oversee the execution of the
training and career development plan. Research and training will occur at Rutgers, which is a ripe environment
for fostering this junior investigator through a transition to research independence. At the conclusion of this
project, the candidat...

## Key facts

- **NIH application ID:** 10885115
- **Project number:** 5K23DK132451-02
- **Recipient organization:** RUTGERS BIOMEDICAL AND HEALTH SCIENCES
- **Principal Investigator:** Gregory Lance Peck
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $228,679
- **Award type:** 5
- **Project period:** 2023-07-15 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10885115

## Citation

> US National Institutes of Health, RePORTER application 10885115, The Natural History of Overall Mortality with Diagnosed Symptomatic Gallstone Disease in the United States: A Sequential Mixed-methods Study Evaluating Emergency, Non-emergency, and No Cholecystectomy (5K23DK132451-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10885115. Licensed CC0.

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