Hasan Al-Obaidi, MD1, Nooraldin Merza, MD2, Hayder Al-Obaidi, MBBCh3, Alhareth Al-Sagban, MD4, Abdallah Kobeissy, MD2 1Jamaica Hospital Medical Center, Briarwood, NY; 2University of Toledo College Medicine and Life Sciences, Toledo, OH; 3Al-Diwaniya Teaching Hospital, Al-Diwaniyah, Al Qadisiyah, Iraq; 4Johns Hopkins University School of Medicine, Bristow, VA
Introduction: Gallbladder disease, which includes disorders such as choledocholithiasis and cholecystitis, is a common health problem globally. The link between cholecystectomy and the risk periampullary tumors (PTs) is uncertain. These malignancies develop in the periampullary region, which is where the pancreatic and common bile ducts meet the duodenum. This region includes the distal common bile duct, the pancreatic head, the periampullary portion of the duodenum, and the ampulla of Vater. These cancers are typically aggressive, with a poor prognosis due to late presentation and restricted therapy choices. The purpose of this systematic review and meta-analysis was to examine the available evidence on this association.
Methods: A systematic literature search was carried out 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 five trials (n = 107,476). A forest plot of individual study RRs and 95% confidence intervals (CIs) showed significant variation in the outcomes. A meta-analysis of five studies found a statistically significant increase in the hazard rate (HR) of primary tumors (PTs) after cholecystectomy (pooled HR: 1.48; 95% CI: 1.14-1.93; p< 0.05).
Discussion: 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 methodology, is required to better understand this link and inform therapeutic decision-making.
Figure: Forest plot relative risk between cholecystectomy and PTs.
Disclosures:
Hasan Al-Obaidi indicated no relevant financial relationships.
Nooraldin Merza indicated no relevant financial relationships.
Hayder Al-Obaidi indicated no relevant financial relationships.
Alhareth Al-Sagban indicated no relevant financial relationships.
Abdallah Kobeissy indicated no relevant financial relationships.
Hasan Al-Obaidi, MD1, Nooraldin Merza, MD2, Hayder Al-Obaidi, MBBCh3, Alhareth Al-Sagban, MD4, Abdallah Kobeissy, MD2. P3457 - Association Between Cholecystectomy and Periampullary Tumor Development: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
