Is Cholecystectomy in Patients with Symptomatic Uncomplicated Cholelithiasis Beneficial in Improving the Lipid Profile?

Abstract

Introduction Gallstone disease is an emerging health issue worldwide with its incidence on the rise. The development of gallstone disease is multifactorial, with risk factors including increased age, female sex, obesity, and the use of oral contraceptive pills. It has been established that more than 50% of patients with gallstone disease have a coexisting lipid disorder. Cholecystectomy, the definitive management of gallstones, may improve the lipid profiles of some patients. Objectives This study aims to examine the postoperative changes in the lipid profiles of patients who underwent cholecystectomy. These lipid profiles include levels of low-density lipoprotein (LDL), triglycerides (TG), high-density lipoprotein (HDL), total cholesterol (TC), and the Chol/HDL ratio. Methods This retrospective study included 55 patients who underwent cholecystectomy between 2013 and 2017. Biochemical parameters, which include LDL, TG, HDL, and TC levels, were collected using the hospital's recording system, in addition to the calculation of the Chol/HDL ratio. Results Statistically significant changes included a reduction in the mean LDL values in the two-, four-, and six-month postoperative periods (P = 0.029, 0.000, and 0.008, respectively), increased mean TG levels one-week postoperatively (P = 0.034), decreased mean TC levels at four (P = 0.049) and six months (P = 0.026) after cholecystectomy, and increased Chol/HDL ratio at two and 12 months postoperatively (P = 0.03, and 0.022, respectively).

Blood lipid metabolism and the risk of gallstone disease: a multi-center study and meta-analysis

“…In this study, TC and LDL cholesterol appeared to be negatively associated with cholecystectomy, but not positively associated with gallstones. Consistent with this, some studies reported that GSD patients who underwent cholecystectomy had decreased levels of TC and triglyceride and increased level of HDL cholesterol [ 30 ], suggesting that cholecystectomy can improve blood lipid levels. In contrast, Chacez-Tapia et al [ 31 ] showed that GSD patients after cholecystectomy had higher levels of LDL cholesterol, triglyceride and TC, but a lower concentration of HDL cholesterol than controls.…”

“…Evidence has shown that patients who underwent cholecystectomy might have different serum lipid profiles compared to those with gallstones [ 30 , 31 ]. In this study, TC and LDL cholesterol appeared to be negatively associated with cholecystectomy, but not positively associated with gallstones.…”

Associations among Lipid Profile, Mucin1 and Cholesterol Ester Transfer Protein Status in Bangladeshi Patients with Cholelithiasis and Effects of Laparoscopic Cholecystectomy on Them

“…As stated earlier, recently Zhang et al reported results of their multi-center cross-sectional study and meta-analysis showing that low HDL cholesterol levels and high triglyceride levels are risk factors for cholelithiasis i.e. GSD and provided a basis to identify the population at high risk for GSD and implementing tertiary prevention strategies for GSD, thus contributing to GSD prevention as well as disease burden relief [26,27]. It is interesting to note that these observations were similar to, and supported, our reported findings on lipid profile in Bangladeshi patients with Cholelithiasis i.e.…”

“…But, Zhang et al did not report any results on the associations (correlations) of lipid profile with Mucin1, CETP or other factors involved in the pathogenetic process of GSD i.e. cholelithiasis [26,27].…”

“…And the results demonstrated that TC and HDL-C were negatively associated with GSD risk, while TG was positively associated with GSD risk. But they did not evaluate and report the associations among serum lipid profile and Mucin1 and also among lipid profile and CETP status in GSD and effects of cholecystectomy on them [26,27].…”