S185 Association Between Cholecystectomy and Periampullary Tumor Development: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
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 5 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 5 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). Conclusion: 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 1).Figure 1.: Forest plot relative risk between cholecystectomy and PTs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.028 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".