根据 2 型糖尿病 (T2D) 状况，调查代谢减肥手术 (MBS) 对肥胖个体胰腺癌 (PCa) 风险的影响。我们按照系统评价的首选报告项目进行了系统评价和荟萃分析和荟萃分析指南（PROSPERO：CRD42022367749）。主要结局是接受 MBS 的患有或不患有 T2D 的参与者与对照组（非 MBS）相比的 PCa 发病率。进行了基于 MBS 类型的亚组分析，并采用了随机效应模型。通过应用留一荟萃分析技术并排除短期随访的研究来进行敏感性分析。使用 I2 指数和 Cochran's Q 检验评估异质性。使用 Egger 检验评估发表偏倚，并使用 Cochrane 偏倚风险工具评估偏倚风险。纳入了 12 项研究，涉及 3,711,243 名参与者。 MBS 组 T2D 和总体人群的 PCa 风险均低于非 MBS 组（分别为 RR = 0.46，95% CI：0.30-0.71 和 RR = 0.21；95% CI：0.07-0.57），排除随访时间< 3 年的研究后得出一致的结果。在没有 T2D 的个体中也观察到了有利的影响（RR = 0.56，95% CI：0.41-0.78）。当比较 MBS 类型与对照组时，观察到袖状胃切除术 (SG) 存在显着差异（SG 的 RR = 0.24；95% CI，0.12-0.46；Roux-En 的 RR = 0.52；95% CI，0.25-1.09） -Y 旁路）。 Egger 的测试显示没有发表偏倚的迹象 (p = 0.417)。无论是否患有 T2D，MBS 都与降低 PCa 风险相关，在 T2D 患者中效果更明显。需要进行更多研究来调查 MBS 类型对 PCa 的影响。© 2024 John Wiley

To investigate the impact of Metabolic-Bariatric surgery (MBS) on pancreatic cancer (PCa) risk in individuals with obesity based on type 2 diabetes(T2D) status.We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines (PROSPERO: CRD42022367749). The primary outcomes were the PCa incidence rates in participants with or without T2D who underwent MBS compared with the control (non-MBS) group. Subgroup analyses based on the MBS types were performed and a random-effects model was employed. Sensitivity analysis was conducted by applying the leave-one-out meta-analysis technique and excluding studies with a short follow-up. Heterogeneity was evaluated using the I2 index and Cochran's Q test. Publication bias was assessed with Egger's test and the risk of bias was assessed with the Cochrane Risk-of-Bias tool.Twelve studies, with 3,711,243 participants, were included. PCa risk was lower in the MBS group for both T2D and the overall population than in the non-MBS group (RR = 0.46, 95% CI: 0.30-0.71 and RR = 0.21; 95% CI: 0.07-0.57, respectively), with consistent findings after excluding studies with < 3-year follow-up. A favourable impact was also observed in individuals without T2D (RR = 0.56, 95% CI: 0.41-0.78). When comparing the types of MBS versus control, a significant difference was observed for sleeve gastrectomy (SG) (RR = 0.24; 95% CI, 0.12-0.46 for SG and RR = 0.52; 95% CI, 0.25-1.09 for Roux-En-Y bypass). Egger's test showed no indication of publication bias (p = 0.417).MBS is associated with reduced PCa risk regardless of T2D, with a more pronounced effect in T2D patients. Additional research is needed to investigate the impact of MBS types on PCa.© 2024 John Wiley & Sons Ltd.