Gallstones and cholecystectomy in relation to risk of liver cancer

The association between gallstones or cholecystectomy and the incidence risk of liver cancer is controversial. This is a meta-analysis of observational studies on the role of gallstones or cholecystectomy in primary liver cancer. Relevant studies were identified after the literature search via electronic databases until June 2014. A random-effects model was used to generate pooled multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity among studies was evaluated using Cochran's Q and I statistics. A total of 14 studies (four case-control, 10 cohort) were included in this study. Our study showed the pooled OR was 2.66 (95% CI: 2.05-3.28) for gallstones with liver cancer risk and OR was 1.47 (95% CI: 1.24-1.71) for cholecystectomy. Though there was obvious heterogeneity among these studies, the risk of incidence was consistent in the subgroup analyses and sensitivity analysis. The findings from meta-analysis provided that patients with gallstones or cholecystectomy had significant increased the risk of liver cancer, although the biological mechanisms underlying the link still need to be clarified.