Incidence risk and risk factors for postcholecystectomy syndrome: A systematic review and meta-analysis.

BACKGROUND

Postcholecystectomy syndrome (PCS) is a clinically significant condition with a variable reported occurrence. This study was conducted to quantitatively synthesize the overall incidence of PCS through meta-analysis and identify its associated risk factors.

METHODS

A comprehensive literature search was conducted across multiple databases, including China National Knowledge Infrastructure, Wanfang, Chinese Technical Sciences Periodical Database‌ (VIP), China Biology Medicine, PubMed, Cochrane Library, Embase, and Web of Science, from inception to April 2025. Cohort and case-control studies investigating the incidence and risk factors of PCS following cholecystectomy were included. Statistical analysis was performed using RevMan 5.4 software.

RESULTS

Nine studies involving 2948 cholecystectomy patients were included in the meta-analysis. The pooled analysis demonstrated that the overall incidence of PCS was 3.21% (95% confidence interval: 2.27-4.55%). Preoperative complications were identified as a strong risk factor for PCS (OR = 26.91, 95% confidence interval: 7.87-92.03, P < .00001).

CONCLUSION

PCS presents a considerable clinical risk, particularly in patients with preexisting symptoms. Clinicians should prioritize preoperative assessment, with special attention to symptomatic patients, and implement individualized perioperative management strategies to mitigate PCS risk.