Gallstones, cholecystectomy and the risk of pancreatic cancer - an updated systematic review and meta-analysis of cohort studies

Q: What was the main purpose of the updated systematic review and meta-analysis?

To clarify the causal relationship between gallstones, cholecystectomy, and the development of pancreatic cancer by pooling cohort-study evidence.

Q: Did gallstones increase the risk of pancreatic cancer overall?

No. The pooled analysis did not show an overall increased risk of pancreatic cancer associated with gallstones.

Q: How did cholecystectomy affect pancreatic cancer risk, and did subgroup results matter?

Cholecystectomy was associated with a higher risk of pancreatic cancer, and the association remained significant across subgroup analyses, with a higher risk observed in the Asian population and in analyses stratified by factors such as sex and lag period.

Sep 28, 2026

Uploaded by Alexandar

Updated evidence synthesis evaluates how gallstones and cholecystectomy relate to pancreatic cancer risk. Cohort studies from PubMed, Web of Science, Embase, and the Cochrane Library up to May 2023 were pooled using a random-effects meta-analytic approach. Sixteen studies were included after screening 1391 articles. Gallstones alone showed no clear association overall, while cholecystectomy demonstrated a significantly higher pancreatic cancer risk, persisting across multiple stratified and confounder-adjusted analyses, especially in Asian populations.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Background and rationale

Prior evidence and unresolved controversies

Gallstones, cholecystectomy and the risk of pancreatic cancer: an updated systematic review and meta-analysis of cohort studies Na Suna , Xudong Wangb and Jichao Weic | The effect of gallstones and cholecystectomy on the development of pancreatic cancer has recently prompted many population-based studies. However, the results are controversial. We conducted an updated systematic review and metaanalysis to explore the causality among gallstones, cholecystectomy and pancreatic cancer. Cohort studies published in the PubMed, Web of Science, Embase, and Cochrane Library databases up to May 2023 were retrieved. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were analyzed using a random-effects model. We screened 1391 articles and included 16 studies. Gallstones were not associated with an increased risk of pancreatic cancer (P = 0.082), with only the Asian population (P = 0.011) showing an increased risk in the subgroup analysis. A markedly higher risk of pancreatic cancer was observed among patients with cholecystectomy (RR = 1.23; 95% CI, 1.07–1.41; P = 0.004; I2 = 74.4%) . The association remained significant in the Asian population (P = 0.004), in the subgroup analyses stratified by sex, lag period, and time interval since cholecystectomy, and when the models were adjusted for diabetes, smoking, and BMI. Interestingly, cholecystectomy due to gallstones (RR = 1.30; 95% CI, 1.14–1.48; P < 0.001; I2 = 30.8%), rather than for unspecified reasons (P = 0. 116), markedly increased the risk of pancreatic cancer. In conclusion, cholecystectomy due to gallstones, rather than gallstone formation, conferred an increased risk for pancreatic cancer. There was a higher risk for the Asian population for both gallstones and cholecystectomy. Eur J Gastroenterol Hepatol 35 : 1313–1323
© 2023 The Author(s) Published by Wolters Kluwer Health Inc | | --- | | Copyright . , . | Introduction Pancreatic cancer is one of the most aggressive digestive malignancies and has become a leading cause of cancer-related mortality [1] . Since patients with pancreatic cancer are usually asymptomatic, this malignant disease is prone to be neglected. Upon diagnosis, the 5-year survival rate was as low as approximately 9% in the USA and Europe in 2019 [2] . Even for surgically resectable patients, the 5-year survival rate is still approximately 15–25%[3] . Thus, studies focusing on risk factors are essential to further elucidate the pathogenesis of pancreatic cancer. European Journal of Gastroenterology & Hepatology 2023, 35:1313–1323 Keywords: cholecystectomy, gallstones, meta-analysis, pancreatic cancer aDepartment of Human Morphology, School of Health and Life Sciences, University of Health and Rehabilitation Sciences, bMinimally Invasive Interventional Therapy Center, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital) and cDepartment of Hepatobiliary Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong Province, China Correspondence to Jichao Wei, MD, Department of Hepatobiliary Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), No.1 Jiaozhou Road, Shibei District, Qingdao 266000, Shandong Province, China Tel: +86 0532 82716767; [e-mail: machineegun@163.com](e-mail: machineegun@163.com)[ ](e-mail: machineegun@163.com)[Received](Received 9 June 2023 Accepted 2 September 2023)[ 9 June 2023](Received 9 June 2023 Accepted 2 September 2023)[ Accepted](Received 9 June 2023 Accepted 2 September 2023)[ 2 September 2023](Received 9 June 2023 Accepted 2 September 2023) . Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, [www.eurojgh.com](www.eurojgh.com). This is an open-access article distributed under the terms of the Creative

FAQs

What was the main purpose of the updated systematic review and meta-analysis?

To clarify the causal relationship between gallstones, cholecystectomy, and the development of pancreatic cancer by pooling cohort-study evidence.

Did gallstones increase the risk of pancreatic cancer overall?

No. The pooled analysis did not show an overall increased risk of pancreatic cancer associated with gallstones.

How did cholecystectomy affect pancreatic cancer risk, and did subgroup results matter?

Cholecystectomy was associated with a higher risk of pancreatic cancer, and the association remained significant across subgroup analyses, with a higher risk observed in the Asian population and in analyses stratified by factors such as sex and lag period.

Sep 28, 2026

Uploaded by Alexandar