Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2015; 21(12): 3679-3693
Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3679
Cholecystectomy and the risk of alimentary tract cancers: A systematic review
Maria Coats, Sami M Shimi
Maria Coats, Sami M Shimi, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, Scotland
Author contributions: Coats M and Shimi SM equally contributed to this paper.
Conflict-of-interest: The authors declare no conflict of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Sami M Shimi, FRCS, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Nethergate, Dundee DD1 9SY, Scotland.
Telephone: +44-1382-383550 Fax: +44-1382-383615
Received: September 30, 2014
Peer-review started: September 30, 2014
First decision: November 14, 2014
Revised: December 5, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: March 28, 2015

AIM: To investigate the association between cholecystectomy and gastro-intestinal tract (GIT) cancers.

METHODS: We conducted a systematic review according to the PRISMA guidelines. A MEDLINE search was performed with predefined search criteria for English Language articles on the association between cholecystectomy and GIT cancers. Additional articles were retrieved by manual search of references. All relevant articles were accessed in full text. Data on study type; cases; controls; country; effect estimate; adjustments for confounders and quality of publication were extracted. The quality of the publications were scored by adherence to the STROBE checklist. The data for each part of the GIT were presented in separate tables.

RESULTS: Seventy-five studies and 5 meta-analyses satisfied the predefined criteria for inclusion and were included in this review. There were inconsistent reports and no strong evidence of an association between cholecystectomy and cancers of the oesophagus (Adenocarcinoma), pancreas, small bowel and right-sided colon cancers. In squamous cancer of the oesophagus, cancers of the stomach, liver, bile ducts, small bowel and left sided colon cancers, good quality studies suggested a lack of association with cholecystectomy. Equally, distal colon and rectal cancers were found not to be associated with cholecystectomy. Several mechanisms for carcinogenesis/promotion of carcinogensis have been proposed. These have focused on a role for bile salts in carcinogenesis with several potential mutagenic molecular events and gut metabolic hormones signaling cell proliferation or initiation of carcinogenesis.

CONCLUSION: This is a comprehensive review of the association between GIT cancers and cholecystectomy. This review found no clear association between cholecystectomy and GIT cancers.

Keywords: Cholecystectomy, Cancer, Gastro-intestinal tract, Carcinogenesis

Core tip: This systematic review explores the association between cholecystectomy and individual gastro-intestinal tract cancers and proposed mechanisms of carcinogenesis. The review finds no clear association between cholecystectomy and cancers of the gastro-intestinal tract.