胆嚢摘出術後の周乳頭部腫瘍発症リスク：システマティックレビューおよびメタアナリシス
Hasan Al-Obaidi1, Nooraldin Merza2, Mustafa Al-Obaidi3
1Department of Hepatology and Gastroenterology, University of Toledo, Toledo, OH.
Background:
The link between cholecystectomy and the risk of periampullary tumors (PTs) is uncertain. The purpose of this systematic review and meta-analysis was to examine the available evidence on this association.
Methods:
A systematic literature search was conducted in PubMed, Embase, and Web of Science for relevant studies published between 1996 and 2024. We considered studies that reported relative risks (RRs) for PTs after cholecystectomy. The Newcastle-Ottawa Scale was used to assess the risk of bias.
Results:
The analysis includes 5 studies (n=107,476). A forest plot of individual study RRs and 95% CIs showed significant variation in the outcomes. A meta-analysis of 5 studies found a statistically significant increase in the hazard rate (HR) of primary tumors (PTs) after cholecystectomy, with a pooled HR of 1.48 (95% CI: 1.14-1.93; P <0.05). However, there was significant heterogeneity (I²=69%, P =0.01175), indicating an elevated risk of PTs associated with cholecystectomy.
Conclusions:
The existing evidence on the link between cholecystectomy and PTs risk is equivocal; however, a pooled study implies an elevated risk. More research, particularly large-scale prospective studies with established methodologies, is needed to better understand this link and inform therapeutic decision-making.
