The Impact of Cholecystectomy on the Gut Microbiota: A Case-Control Study

Abstract

Cholecystectomy alters the bile flow into the intestine and the enterohepatic circulation of the bile acids; this may affect the gut microbiota. We assessed the gut microbiota composition of patients who had undergone cholecystectomy and compared with those who had not. From a cohort of 1463 adult participants who underwent comprehensive health screening examinations, 27 subjects who had undergone cholecystectomy (cholecystectomy group) and 81 age- and sex-matched subjects who had not (control group) were selected. Clinical parameters were collected and compared. Microbial composition was determined by 16S rRNA gene sequencing of DNA extracted from fecal samples. We evaluated differences in the overall microbial composition and in the abundance of taxa. The two groups were comparable with respect to clinical characteristics and laboratory results. The actual number of taxa observed in a sample (observed features) was significantly lower in the cholecystectomy group than in the control group (p = 0.042). The beta diversity of Jaccard distance index was significantly different between the two groups (p = 0.027). Blautia obeum and Veillonella parvula were more abundant in the cholecystectomy group. The difference in the diversity of the gut microbiota between the cholecystectomy and control groups was subtle. However, B. obeum and V. parvula, which have azoreductase activity, were more abundant in the cholecystectomy group. The impact of such changes in the gut microbiota on health remains to be determined.

The Effect of Cholecystectomy on the Risk of Colorectal Cancer in Patients with Gallbladder Stones

“…Second, cholecystectomy can increase the risk of CRC by enhancing the risk of the metabolic syndrome due to the impairment of cholesterol metabolism [26,34,35]. Third, cholecystectomy can change the activity of colonic microbiota, which can also lead to the development of CRC [36,37]. However, our study does not demonstrate the detrimental effect of cholecystectomy on the development of CRC, therefore, these explanations above hardly support our findings.…”

Gallstone Disease and Microbiome

“…Cholecystectomy leads to a significant change in the composition of the gut microbiota [ 9 , 12 ]. After cholecystectomy, an even more pronounced decrease in the actual number of taxa occurs compared with individuals without GSD [ 9 , 11 ] and an increase in the number of Bifidobacterium and Anaerostipes Dorea [ 11 ]. In some individuals, an increase in the species B. obeum and V. Parvula (type Firmicutes ) [ 9 , 11 ] and Bacteroidetes [ 13 ] is noted.…”

“…In 1966, Maki [ 6 ] showed the role of bacterial infection in the pathogenesis of pigmented gallstones. Later, in several works, it was demonstrated that changes in the gut microbiota are also one of the etiological factors of cholesterol gallstones [ 7 , 8 , 9 ].…”

Bacterial Alterations in Post-Cholecystectomy Patients Are Associated With Colorectal Cancer

“…A study in China found that gut bacterial composition in healthy people changed with age, but the change was lost in PC patients, and the abundance of Bacteroidetes decreased in PC patients ( 18 ). Additionally, another study which contained 27 PC patients showed a subtle difference in the diversity of gut microbiota between the cholecystectomy and control groups ( 19 ). Nevertheless, these previous results were controversial, and the characterization in gut microbiota after cholecystectomy is still unclear.…”