Background/Objectives:Cholecystectomy (CE) is among the most commonly performed surgical procedures worldwide. While it effectively treats gallstone disease, concerns have been raised about a potential long-term association with colorectal cancer (CRC), given overlapping risk factors and post-surgical physiological changes. Previous studies have reported inconsistent findings. This updated systematic review aimed to reassess the association between CE and CRC risk by incorporating the most recent evidence.Methods:In accordance with PRISMA 2020 guidelines, a systematic literature search was conducted in PubMed, Embase, Medline, Web of Science, and the Cochrane Library for studies published after May 2022. Eligible studies were observational cohort studies reporting relative risk estimates for CRC following CE. Data were extracted manually, and study quality was assessed using the NewcastleOttawa Scale (NOS). Only high-quality studies were included to update the systematic review. Publication bias was assessed using funnel plots and Egger’s test.Results:Out of 156 identified records, three new high-quality cohort studies met the inclusion criteria and were added to the 18 studies from the previous review, resulting in a total of 21 studies. The findings were heterogeneous: while no consistent association with overall CRC risk was observed, several studies reported an elevated risk of proximal (right-sided) colon cancer following CE. Egger’s test indicated no significant publication bias (p= 0.50).Conclusions:This updated systematic review suggests a potential association between CE and an increased risk of proximal colon cancer; however, the evidence remains inconclusive. Further prospective studies with robust confounder control and detailed tumor location-specific analyses are warranted to clarify causality and guide future screening strategies.
**背景/目的：** 胆囊切除术是全球范围内最常实施的外科手术之一。尽管该手术能有效治疗胆石症，但由于其与结直肠癌存在重叠的风险因素及术后生理变化，人们对其可能与结直肠癌存在长期关联表示担忧。既往研究结果并不一致。本次更新的系统综述旨在纳入最新证据，重新评估胆囊切除术与结直肠癌风险之间的关联。 **方法：** 遵循PRISMA 2020指南，系统检索了PubMed、Embase、Medline、Web of Science及Cochrane Library数据库中2022年5月后发表的研究。纳入标准为报告胆囊切除术后结直肠癌相对风险估计值的观察性队列研究。数据通过人工提取，研究质量采用纽卡斯尔-渥太华量表进行评估。仅纳入高质量研究以更新系统综述。通过漏斗图和Egger检验评估发表偏倚。 **结果：** 在初步检索到的156篇文献中，3项新发表的高质量队列研究符合纳入标准，与先前综述中的18项研究合并，共计21项研究。研究结果存在异质性：虽然未观察到与总体结直肠癌风险的一致关联，但多项研究报告胆囊切除术后近端（右侧）结肠癌风险升高。Egger检验未显示显著发表偏倚（p=0.50）。 **结论：** 本次更新的系统综述提示，胆囊切除术可能与近端结肠癌风险升高存在潜在关联，但证据仍不充分。未来需开展进一步的前瞻性研究，加强混杂因素控制并进行详细的肿瘤部位特异性分析，以明确因果关系并为筛查策略提供依据。
Colorectal Cancer Risk Following Cholecystectomy: An Updated Systematic Review
肿瘤(癌症)患者之家