In addition to the known link between cholecystectomy and depression, the risk of developing short-term and long-term depression after surgery and whether such mental health issues leads to suicide were not known. Therefore, this study aimed to address these questions. Using data from the National Health Insurance Service of Korea (2002–2019), we conducted a retrospective cohort study including 6,688 cholecystectomy patients matched with 66,880 individuals without a history of cholecystectomy for suicide analysis and 6,694 cholecystectomy patients matched with 66,940 individuals for depression analysis. The non-cholecystectomy group was matched at a 1:10 ratio for sex and age. The incidence of depression and suicide were followed from the day of cholecystectomy to December 31, 2019. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression. Short-term depression risk within three years of cholecystectomy was significantly elevated (aHR 1.38, 95% CI 1.19–1.59), while the long-term depression risk beyond three years was not significantly greater (aHR 1.09, 95% CI 0.98–1.22). Cholecystectomy was not associated with an increased risk of suicide in any period. These findings highlight the importance of monitoring and providing postoperative mental health support for patients at risk of short-term depression after cholecystectomy. However, no association was observed with long-term depression or suicide risk.

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