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Year : 2014  |  Volume : 10  |  Issue : 4  |  Page : 834-838

Cholelithiasis, cholecystectomy and risk of hepatocellular carcinoma: A meta-analysis

Department of General Surgery, Key Laboratory of Digestive System Tumors, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province, China

Correspondence Address:
Prof. Yumin Li
Department of General Surgery, Key Laboratory of Digestive System Tumors, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.135992

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Available evidence of the relationship between cholelithiasis, cholecystectomy, and risk of liver cancer and hence we conducted a meta-analysis to investigate the relationships. PubMed, EMBASE, and ISI Web of Knowledge were searched to identify all published cohort studies and case-control studies that evaluated the relationships of cholelithiasis, cholecystectomy and risk of liver cancer and single-cohort studies which evaluated the incidence of liver cancer among patients who understood cholecystectomy (up to February 2013). Comprehensive meta-analysis software was used for meta-analysis. A total of 11 observational studies (six cohort studies and five case-control studies) were included in this meta-analysis. The result from meta-analysis showed that cholecystectomy (risk ratio [RR]: 1.59, 95% confidence interval [CI]: 1.01-2.51, I2 = 72%) and cholecystolithiasis (RR: 5.40, 95% CI: 3.69-7.89, I2 = 93%) was associated with more liver cancer, especially for intrahepatic cholangiocarcinoma (ICC) (cholecystectomy: RR: 3.51, 95% CI: 1.84-6.71, I2 = 26%; cholecystolithiasis: RR: 11.06, 95% CI: 6.99-17.52, I2 = 0%). The pooled standardized incidence rates (SIR) of liver cancer in patients who understood cholecystectomy showed cholecystectomy might increase the incidence of liver cancer (SIR: 1.57, 95% CI: 1.13-2.20, I2 = 15%). Based on the results of the meta-analysis, cholecystectomy and cholecystolithiasis seemed to be involved in the development of liver cancer, especially for ICC. However, most available studies were case-control studies and short-term cohort studies, so the future studies should more long-term cohort studies should be well-conducted to evaluate the long-term relationship.

Abstract in Chinese

胆结石、胆囊切除术和肝细胞癌的风险:一项荟萃分析 摘要 现有的证据证实胆石症、胆囊切除术与肝癌的风险之间的关系,因此我们进行了一项荟萃分析研究。在PubMed,EMBASE,ISI Web of Knowledge中进行检索,找出所有发表关于胆石症、胆囊切除、肝癌的关系的队列研究和病例对照研究评价,和单队列研究评估了胆囊切除术患者的肝癌的发病率(至2013年2月)。综合分析软件进行Meta分析。共有11个观察性研究(6项队列研究和5个病例对照研究)进行Meta分析。从元分析结果表明,胆囊切除术(风险比[RR]:1.59,95%可信区间[CI]:1.01-2.51,I2 = 72%)和胆囊结石(RR :5.40,95% CI:3.69-7.89,I2 = 93%)与肝癌相关,特别是肝内胆管细胞癌(ICC)(胆囊切除术:RR:3.51,95%可信区间:1.84-6.71,I2 = 26%;胆囊结石:RR: 11.06,95% CI:6.99-17.52,I2 = 0)。汇集肝癌标准化发病率(SIR)接受胆囊切除术者可能会增加肝癌的发生率(SIR:1.57,95%可信区间:1.13-2.20,I2 = 15%)。基于Meta分析的结果,胆囊切除、胆囊结石似乎在肝癌发展过程中有关,尤其是肝内胆管细胞癌。但是多数病例对照研究是短期研究,因此,未来的研究应该更多地进行长期队列研究,并行长期关系的评估。 关键词:胆囊切除术,胆囊结石,肝肿瘤,Meta分析

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