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Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis

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  • Yanqiong Liu
  • Yu He
  • Taijie Li
  • Li Xie
  • Jian Wang
  • Xue Qin
  • Shan Li

Abstract

Background: Recent epidemiological evidence points to an association between gallstones or cholecystectomy and the incidence risk of liver cancer, but the results are inconsistent. We present a meta-analysis of observational studies to explore this association. Methods: We identified studies by a literature search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and relevant conference proceedings up to March 2014. A random-effects model was used to generate pooled multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Between-study heterogeneity was assessed using Cochran’s Q statistic and the I2. Results: Fifteen studies (five case-control and 10 cohort studies) were included in this analysis. There were 4,487,662 subjects in total, 17,945 diagnoses of liver cancer, 328,420 exposed to gallstones, and 884,507 exposed to cholecystectomy. Pooled results indicated a significant increased risk of liver cancer in patients with a history of gallstones (OR = 2.54; 95% CI, 1.71–3.79; n = 11 studies), as well as cholecystectomy (OR = 1.62; 95% CI, 1.29–2.02; n = 12 studies), but there was considerable heterogeneity among these studies. The effects estimates did not vary markedly when stratified by gender, study design, study region, and study quality. The multivariate meta-regression analysis suggested that study region and study quality appeared to explain the heterogeneity observed in the cholecystectomy analysis. Conclusions: Our results suggest that individuals with a history of gallstones and cholecystectomy may have an increased risk of liver cancer.

Suggested Citation

  • Yanqiong Liu & Yu He & Taijie Li & Li Xie & Jian Wang & Xue Qin & Shan Li, 2014. "Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-9, October.
    • Handle: RePEc:plo:pone00:0109733
    DOI: 10.1371/journal.pone.0109733
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Xian-bin Zhou & Li-ping Ye & Xin-li Mao & Jian-fen Wu & Cai yue & Bin-bin Gu & Yu-Zhang & Jin-bang Peng & Shao-wei Li & Min Quan & Kuai Ma & Shi-wen Xu & Li Wang, 2020. "The Advantages and Disadvantages of Transgastric Natural Orifice Transluminal Endoscopic Gallbladder-Preserving Surgery Compared with Traditional Operation and its Clinical Application," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 30(2), pages 23309-23313, September.

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