title: Increased Risk of Pancreatic Cancer Related to Gallstones and Cholecystectomy: A Systematic Review and Meta-Analysis.
abstract: To investigate the potential roles of gallstones and cholecystectomy in pancreatic carcinogenesis, we performed the first meta-analysis of all currently published studies by pooling relative risks (RRs) with 95% confidence intervals (95% CIs). Stratified analysis by ethnicity, study design, and common adjusted factors were also conducted. Individuals with a history of gallstones and cholecystectomy were at increased risk of pancreatic cancer (RR, 1.39; 95% CI, 1.28-1.52; P < 0.001). Gallstones and cholecystectomy were also associated with an elevated risk of pancreatic cancer, respectively (for gallstones: RR, 1.70; 95% CI, 1.30-2.21; P < 0.001; for cholecystectomy: RR, 1.31; 95% CI, 1.19-1.43; P < 0.001). The positive association is observed among not only the Asian population but also whites. The pooled findings were further confirmed by sensitivity analysis and stratified analyses in case-control and cohort studies. Stratified analyses by different adjusted factors further showed that the increased risk of pancreatic cancer was independent of confounders including diabetes, obesity, smoking, and follow-up years of postcholecystectomy. A history of gallstones and cholecystectomy is a robust risk factor for pancreatic cancer. Gallstone disease or cholecystectomy alone is also an independent risk factor for pancreatic carcinogenesis.
authors.affiliation: From the *Departments of General Surgery and †Anesthesiology, The First Affiliated Hospital of Henan Science and Technology University, Luoyang, Henan Province; and ‡Department of Physiology, The Basic Medicine College of Weifang Medical University, Weifang, Shandong Province, China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Fan
authors.forename: Jie
authors.initials: J
authors.lastname: Hu
authors.forename: Bing
authors.initials: B
authors.lastname: Feng
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Guoliang
authors.initials: G
authors.lastname: Yao
authors.forename: Jingming
authors.initials: J
authors.lastname: Zhai
authors.forename: Xin
authors.initials: X
authors.lastname: Li
mesh_terms: D016022:Case-Control Studies; D002763:Cholecystectomy / Q000009:adverse effects*; D015331:Cohort Studies; D042882:Gallstones / Q000150:complications*; D006801:Humans; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000209:etiology*; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors