Abstract
BACKGROUND: Several observational studies suggest a potential association between cholecystectomy and the risk of developing microscopic colitis (MC). However, the current findings remain inconsistent. OBJECTIVES: To address this discrepancy, we conducted a systematic review and meta-analysis to comprehensively assess the association between cholecystectomy and the risk of MC. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies evaluating the association between cholecystectomy and MC risk. Studies were eligible if they reported effect estimates or provided sufficient data for calculation. Two independent authors extracted the data and assessed the quality of included studies. A random-effects model was used to pool odds ratios (ORs), with subgroup analyses performed according to patient characteristics and study quality. RESULTS: Six observational studies were included in the final analysis. The pooled OR was 0.80 (95% confidence interval: 0.52-1.22), and sensitivity analysis confirmed the robustness of the results, indicating no significant association between cholecystectomy and MC risk. Subgroup analyses based on geographic location, study design, study quality, methods of cholecystectomy data collection, control populations, and MC subtypes consistently showed no significant association. CONCLUSION: Current evidence suggests no statistically significant association between cholecystectomy and the risk of MC. Future research should include populations with diverse geographic and ethnic backgrounds, utilize medical records for accurate surgical history, and account for potential confounding factors. Large-scale prospective studies will be essential to obtain more reliable and definitive conclusions. TRIAL PROSPERO REGISTRATION: CRD42024592056.