Development of functional gastrointestinal disorder symptoms following laparoscopic cholecystectomy: a prospective cohort study

Abstract

BackgroundThe casual relationship between the role of cholecystectomy and functional gastrointestinal disorders (FGIDs) are a controversial clinical challenge. This study aimed to investigate: (1) the overlap of FGIDs before cholecystectomy and its long-term outcome after surgery in patients with symptomatic cholelithiasis, and (2) the incidence of new-onset FGIDs after cholecystectomy.MethodsPatients with symptomatic gallstone disease who underwent elective, laparoscopic cholecystectomy were prospectively enrolled. Healthy populations who underwent medical check-ups were selected as age- and sex-matched controls. Questionnaires regarding sociodemographic characteristics, gastrointestinal symptoms and a somatization symptom checklist (SSC) were completed at baseline and 12 months thereafter.ResultsThe prevalence of all FGID symptoms before cholecystectomy were significantly higher in the group of patients with symptomatic cholecystolithiasis compared to the control group. In cholecystectomy group, the preoperative FGID symptoms improved after surgery, except for chronic diarrhea. Compared to the controls, the new-onset FGIDs, including functional dyspepsia (14.8% vs. 6.9%; p = 0.040), functional diarrhea (6.6% vs. 0.2%; p < 0.001), and chronic abdominal pain (11.9% vs. 4.4%; p = 0.024), were more common at 1 year after cholecystectomy. Somatization was independent predictors of new-onset dyspepsia and abdominal pain, while newly occurring diarrhea was not realted to somatization.ConclusionOverlap of FGIDs was common in patients with symptomatic cholelithiasis before surgery and at follow-up 1 year after cholecystectomy. Furthermore, new-onset FGIDs could be occurred after cholecystectomy. Therefore, a delicate diagnostic approaches and appropriate treatments about co-existent FGIDs should be given in patients with cholelithiasis before and after cholecystectomy.

Analysis of quality of life in patients after transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery

“…Further analysis of the data showed that 2 out of 40 patients in the EGPS group complained of an increase in the frequency of stool after surgery, while 8 of the patients in the LC group complained of an increase in the frequency of stool compared with before surgery, diarrhea or diarrhea worse than before surgery, ranging from 1 wk to 6 months after surgery. The study by Chang et al [ 12 ] showed that at one year of follow-up after cholecystectomy, a large number of patients developed symptoms of persistent functional gastrointestinal disease, including diarrhea, which is similar to our study. The causes of diarrhea after cholecystectomy may be related to changes in bile acid metabolism[ 13 ], changes in the intestinal immune environment[ 14 ], dysbiosis[ 6 ], etc .…”