胆囊切除术后是否增加结直肠癌（CRC）发生风险一直是消化外科领域长期关注的问题。胆囊切除术后胆汁酸代谢改变，导致次级胆汁酸生成增加和肠道微生态失调，肠道动力和免疫调节异常在一定程度上也为CRC发生发展提供了有利条件。右半结肠尤其是近端结肠被认为是主要风险部位，在特定人群中更为显著。但目前该领域研究仍存在样本量小、手术指征混杂、对疾病整体把握不足及未排除人群异质性影响等局限性。因此，现有证据尚不足以支持将胆囊切除术作为CRC发生的独立危险因素。未来研究应侧重于开展更多设计严谨、长期随访的前瞻性队列研究和Meta分析排除混杂因素的影响，从整体层面进一步探讨胆囊切除和CRC发生的因果关联，以期为临床决策提供更可靠的循证依据，提升病人手术效果和总体生存质量。

Whether cholecystectomy increases the risk of colorectal cancer (CRC) has long been a topic of interest in the field of digestive surgery. Post-cholecystectomy alterations in bile acid metabolism lead to increased secondary bile acid production and gut microbiota dysbiosis, while abnormalities in gut motility and immune regulation create favorable conditions for CRC development to some extent. The right half of the colon, particularly the proximal colon, is considered the primary risk site, with more pronounced effects in specific populations. However, current research in this area still faces limitations such as small sample sizes, confounding surgical indications, insufficient disease understanding, and failure to account for population heterogeneity. Therefore, existing evidence is insufficient to support the classification of cholecystectomy as an independent risk factor for CRC. Future studies should focus on conducting more rigorously designed, long-term prospective cohort studies and meta-analyses to eliminate confounding factors, further exploring the causal relationship between cholecystectomy and CRC at a systemic level. This will aim to provide more reliable evidence-based guidance for clinical decision-making, improving surgical outcomes and overall quality of life for patients.