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Relationship between pancreaticobiliary maljunction and gallbladder carcinoma: meta-analysis
Yi-Lei Deng1, Nan-Sheng Cheng, Yi-Xin Lin
1Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Hepatobiliary & Pancreatic Diseases International : HBPD INT
|December 8, 2011
Summary
Pancreaticobiliary maljunction (PBM) significantly increases gallbladder carcinoma (GBC) risk, particularly the P-C type without common bile duct dilation. Laparoscopic cholecystectomy is recommended for PBM patients without dilation, especially young females without gallstones.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Conflicting reports exist on the association between pancreaticobiliary maljunction (PBM) and gallbladder carcinoma (GBC).
- The prevalence and clinical characteristics of GBC in patients with PBM require further clarification.
Purpose of the Study:
- To systematically evaluate the relationship between PBM and GBC.
- To identify clinical features of GBC patients associated with PBM.
Main Methods:
- A meta-analysis of nine case-control studies was conducted.
- Studies were identified through comprehensive searches of PubMed and Web of Science databases.
- Data extraction and analysis were performed rigorously by two independent reviewers.
Main Results:
- PBM was significantly more prevalent in GBC patients (10.60%) compared to controls (1.76%), with an odds ratio (OR) of 7.41 (P<0.00001).
- GBC patients with PBM were younger (SMD: -9.90, P<0.00001) and had a lower incidence of gallstones (OR: 0.09, P<0.00001).
- The P-C type of PBM without congenital dilatation of the common bile duct was frequently observed in GBC patients.
Conclusions:
- PBM is a significant risk factor for GBC development, especially the P-C type without common bile duct dilation.
- Laparoscopic cholecystectomy is recommended for PBM patients without common bile duct dilation, particularly young females without gallstones, to prevent GBC.
