title: Cholelithiasis, cholecystectomy and risk of hepatocellular carcinoma: a meta-analysis.
abstract: 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.
authors.forename: Lingyun
authors.initials: L
authors.lastname: Guo
authors.forename: Jie
authors.initials: J
authors.lastname: Mao
authors.affiliation: Department of General Surgery, Key Laboratory of Digestive System Tumors, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province, China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Li
authors.forename: Zuoyi
authors.initials: Z
authors.lastname: Jiao
authors.forename: Jiwu
authors.initials: J
authors.lastname: Guo
authors.forename: Junqiang
authors.initials: J
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology; D002763:Cholecystectomy / Q000009:adverse effects*; D002769:Cholelithiasis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology