Negative correlation between cholecystectomy and the subsequent development of large bowel carcinoma in a low-risk Japanese population

Abstract

The incidence of previous cholecystectomy in a series of 541 patients with colorectal cancer and 1832 patients with stomach cancer was studied. Five patients (0.92 percent) with colorectal cancer and eight (0.44 percent) with stomach cancer had undergone previous cholecystectomy. To avoid biases in the two groups of patients, 416 pairs of patients, comparable in sex, age, and time of admission for cancer treatment, were matched from each group to compare the number of patients who had undergone previous cholecystectomy. Within these matched pairs, three patients with colorectal cancer and two with stomach cancer had histories of cholecystectomy. Hence, no substantial difference was noted between the two groups. In a follow-up study of 461 patients who had undergone cholecystectomy for gallstones, large bowel carcinoma and stomach carcinoma developed in one and six patients, respectively, during an observation period of four to 36 years. The ratio of patients with large bowel cancer to those with stomach cancer observed in this survey was almost equal to the value estimated for the population of Tottori Prefecture, where the majority of the patients reside. The incidence of large bowel carcinoma is not increased among cholecystectomized patients in a low-risk Japanese population.

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

“…However, other studies [ 17 , 18 ] have suggested conflicting results, indicating that there was no relation between cholecystectomy and CRC. One study from Japan [ 19 ] revealed a negative correlation between cholecystectomy and large bowel carcinoma. Another meta-analysis [ 20 ] discussed the relation between cholecystectomy and large bowel carcinoma by separately analyzing cohort studies and case-control studies, but the results were also conflicting.…”

The Effect of Cholecystectomy on the Risk of Colorectal Cancer in Patients with Gallbladder Stones

“…No association between cholecystectomy and CRC was observed in a former meta-analysis by analyzing the cohort and case-control studies [12]. By contrast, a positive aforementioned association was observed in a recent meta-analysis based on 10 cohort studies [13,14]. However, we find that all the control cohorts are in the general population, rather than the patients with GBS; therefore, the contribution of GBS to the development of CRC might have been overlooked in the former studies.…”

“…More than 80% of GBS will remain symptom-free and only 3% of the symptomatic GBS will develop acute cholecystitis; therefore, prophylactic cholecystectomy is not indicated for asymptomatic GBS [21,22,46]. The ameliorating effect of cholecystectomy on the development of CRC may be underappreciated in the former studies due to erroneous comparison with the general population [12][13][14]. However, we could not recommend prophylactic cholecystectomy for the prevention of CRC simply based on our observational study since the number needed to treat (NNT) per year (6 months or longer after cholecystectomy) for cholecystectomy for preventing one CRC was 1408 (1000/2.21-1.50) in our study.…”

Risk of Missing Colorectal Cancer During Laparoscopic Cholecystectomy

“…We subsequently found rectal cancer in one patient among those scheduled for LC. According to our review of the literature, little is known about the frequency of missed colorectal cancer during open cholecystectomy, although the rate of colorectal cancer occurrence following cholecystectomy has been reported to range from 0.2% to 2.1% 17,18 in follow-up of 30 years or more postoperatively. In addition, the rate of a concomitant diagnosis of colorectal cancer in patients with cholelithiasis has been reported to range from 1.3% to 3.7%.…”