The effect of cholecystectomy on the risk of colorectal cancer: A systematic review and meta-analysis

Objective

Some studies have found that cholecystectomy may increase the risk of colorectal cancer (CRC), while others have reached inconsistent conclusions. We thus performed a systematic review and meta-analysis to assess the incidence rate of CRC after cholecystectomy for patients with gallstones or gallbladder diseases, and whether the geographical location of the patients affected the results.

Methods

We systematically searched PubMed, Embase, and Cochrane for studies reporting changes in the incidence rate of CRC after cholecystectomy published before January 12, 2023. Our main endpoint was the occurrence of CRC. Data were extracted and pooled, and the relative risk (RR) and 95% confidence interval (CI) were calculated. We assessed pooled data using a random-effects model.

Results

In total, 477 articles were identified, and 6 articles were eligible, including 7 studies that included 797,917 participants. Overall, the summarized research results showed that the risk of CRC was reduced in patients with gallbladder diseases who underwent cholecystectomy (RR: 0.80, 95% CI: 0.65 to 0.99, p = 0.040; I² = 85.0%). In the subgroup analysis based on different geographical locations, cholecystectomy was not associated with the risk of CRC in the Western population (RR: 0.90, 95% CI: 0.65 to 1.25, p = 0.522; I² = 86.5%), but there was a negative correlation between cholecystectomy and the risk of CRC (RR: 0.66, 95% CI: 0.60 to 0.73, p = 0.000) in the Chinese population.

Conclusions

Our findings support that for patients with gallstones or gallbladder diseases, the incidence of CRC after cholecystectomy is lower than that of patients who do not undergo cholecystectomy.