The effect of cholecystectomy for symptomatic gall stone disease on hepatic steatosis using transabdominal ultrasonography: An observational prospective study
Umang Dhakaria1
, Rajesh Kumar Bansiwal1, Agrawal Kavita Khemchand1, Rajeev Sharma1, Mandeep Singh1, Narinder Kaur2, Seema Gupta3
1 Clinic of General Surgery, Government Medical College and Hospital, Chandigarh, India
2 Clinic of Radiology, Government Medical College and Hospital, Chandigarh, India
3 Clinic of Biochemistry, Government Medical College and Hospital, Chandigarh, India
Abstract
Objective: Hepatic steatosis and gallstones are common in the general population, with risk factors being multifactorial. Experimental studies have shown that cholecystectomy increases hepatic steatosis and leads to non-alcoholic fatty liver disease (NAFLD). In order to evaluate this, the current study was carried out in the department of general surgery at a medical school, in the north of India.
Material and Methods: One hundred and three patients awaiting cholecystectomy were selected after written informed consent. Their baseline characteristics were captured preoperatively and thereafter followed at 3rd month with liver function test (LFT), lipid profile and ultrasound (USG) abdomen.
Results: Average age of the patients enrolled was 41.62 ± 13.62 years and mean body mass index (BMI) was 25.96 ± 1.73 kg/m2 . Total bilirubin (0.56 vs 0.76, p< 0.0001) and direct bilirubin (0.15 vs 0.27, p< 0.0001) decreased significantly post cholecystectomy as compared to preoperative values. Levels of serum glutamic-oxaloacetic transaminase (SGOT) (49.14 vs 34.98 IU/dL), serum glutamic-pyruvic transaminase (SGPT) (50.85 vs 35.46 IU/dL) and alkaline phosphatase (ALP) (101.16 vs 85.97 IU/dL) increased significantly post-surgery. Cholesterol values (146.28 vs 168.77 mg/dL), triglycerides (TGs) (119 vs 133.56 mg/dL), low density lipoprotein (LDL) (93.32 vs 113.05 mg/dL) and very low density lipoprotein (VLDL) (18.68 vs 27.45 mg/dL) decreased significantly while high density lipoprotein (HDL) (48.96 vs 42.42 mg/dL) increased significantly at three month follow-up. Prevalence of fatty liver increased post operatively with a rise in Grade 1 steatosis (75%). Severity of fatty liver increased with (8.73%) Grade 3 steatosis on USG post-surgery. Hence, new patients with formerly normal USG reports developed fatty liver and those with preexisting liver steatosis seemed to worsen.
Conclusion: The study concluded that the prevalence of fatty liver increased post-cholecystectomy. Lipid profile parameters improved favorably with a decline in total cholesterol, TG, LDL and VLDL versus increase in HDL. LFT parameters also changed significantly.
Keywords: Cholecystectomy, hepatic steatosis, liver function test, lipid profile, ultrasound abdomen
Cite this article as: Dhakaria U, Bansiwal RK, Kavita Khemchand A, Sharma R, Singh M, Kaur N, et al. The effect of cholecystectomy for symptomatic gall stone disease on hepatic steatosis using transabdominal ultrasonography: An observational prospective study. Turk J Surg 2024; 40 (4): 320-327.
This study was approved by Government Medical College and Hospital Institutional Ethics Committee (Decision no: GMCH/IEC/835/2022/197, Date: 29.11.2022).
Externally peer-reviewed.
Concept - UD; Design - RB; Supervision - RB; Materials - UD; Data Collection and/or Processing - UD; Analysis and/or Interpretation - RB; Literature Search - MS; Writing Manuscript - KA; Critical Reviews - RB, RS, NK, SG.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.