Changes in the Lipid Profiles of Pre- and Post-Cholecystectomy Patients: A Systematic Review and Meta-Analysis
Lipid Profiles Pre- and Post-Cholecystectomy
Background: Patients with gallstones often exhibit irregular lipid profiles, such as hyperlipidemia, which may cause various morbidities. Gallstone treatment by cholecystectomy can alter bile acids, subsequently impacting the lipid profile. This study aimed to analyze the effects of cholecystectomy on lipid profiles.
Methods: This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane, ProQuest, and Google Scholar were utilized to discover prospective or retrospective cohort studies, cross-sectional studies, and non-randomized trials. The inclusion criteria were studies comparing lipid profiles pre- and post-cholecystectomy in the same patients, conducted on humans, and published in English with full text available. Abstracts from conferences, case studies/series, review articles, letters, editorials, and research published in languages other than English were excluded. A meta-analysis was conducted on patient outcomes using random- or fixed-effect models to generate pooled odds ratios (OR) with 95% confidence intervals (CI). A significant change in lipid profiles was indicated by p<0.05.
Results: There were 17 selected studies involving 1,691 participants. Within less than a week, cholecystectomy significantly decreased total cholesterol and low-density lipoprotein (LDL). During one-month follow-ups, cholecystectomy significantly increased high-density lipoprotein (HDL) while reducing other lipid profile markers, including total cholesterol, LDL, and triglycerides. During follow-ups beyond one month, there were no significant changes in lipid profiles.
Conclusion: Cholecystectomy decreases total cholesterol and LDL within days and improves all lipid profile markers a month post-surgery. Beyond one month, it does not exhibit significant changes in lipid profiles.
Highlights:
- This is the first systematic review and meta-analysis that provides valuable insights into the effects of cholecystectomy on lipid profile.
- This study offers a foundation for more effective postoperative management strategies to mitigate cardiovascular disease risks.
- This study may also be the foundation of theories regarding the advantage of cholecystectomy for improving lipid profile.
Ahi KS, Singh RP, Kaur H, Moudgil A (2017). Serum lipid profile in pre and post cholecystectomy patients. International Journal of Anatomy Radiology and Surgery 6(2): SO01–SO06. Retrieved from http://www.jcdr.net//back_issues.aspx?issn=0973-709x&year=2017&month=April&volume=6&issue=2&page=SO01 - SO06&id=2267 .
Al-Kataan MAG, Bashi AYD, Al-Khyatt MK (2010). Some serum lipid profile and glucose levels pre- and post - cholecystectomy. Journal of the Bahrain Medical Society 22(1): 18–22. Retrieved from https://www.cabidigitallibrary.org/doi/full/10.5555/20113111367.
Al-Salih RMH, Abduredha M, Yousif SY (2018). Effect of cholecystectomy on serum lipid profile pre and post operation. European Journal of Pharmaceutical and Medical Research 5(11): 13–19. Retrieved from https://www.ejpmr.com/home/abstract_id/4334.
Aydin A, Öztürk D (2022). Effects of cholecystectomy on lipid profile. Journal of Experimental and Clinical Medicine 39(4): 1246–1248. doi: 10.52142/omujecm.39.4.54.
Batajoo H, Hazra N (2013). Analysis of serum lipid profile in cholelithiasis patients. Journal of Nepal Health Research Council 11(23): 53–55. Retrieved from http://www.jnhrc.com.np/index.php/jnhrc/article/view/345/344#.
Chang Y, Lin HM, Chi KY, Lin WY, Chou TC (2023). Association between statin use and risk of gallstone disease and cholecystectomy: A meta-analysis of 590,086 patients. PeerJ 11: e15149. doi: 10.7717/peerj.15149.
Chen YS, Wu SD, Tian Y (2018). Cholecystectomy as a risk factor of metabolic syndrome: From epidemiologic clues to biochemical mechanisms. Laboratory Investigation 98(1): 7–14. doi: 10.1038/labinvest.2017.95.
Di Ciaula A, Garruti G, Wang DQH, Portincasa P (2018). Cholecystectomy and risk of metabolic syndrome. European Journal of Internal Medicine 53: 3–11. doi: 10.1016/j.ejim.2018.04.019.
Fathi M, Soori M, Rashnoo F, Hajinasrollah E (2019). Cholecystectomy: Long term effect on serum lipid profile and vitamin D. Researcher Bulletin of Medical Sciences 24(1): e9. Retrieved from https://journals.sbmu.ac.ir/index.php/rbms/article/view/32162.
Feng L, Nian S, Tong Z, Zhu Y, Li Y, et al. (2020). Age-related trends in lipid levels: A large-scale cross-sectional study of the general Chinese population. BMJ Open 10(3): e034226. doi: 10.1136/bmjopen-2019-034226.
Gill GS, Gupta K (2017). Pre- and post-operative comparative analysis of serum lipid profile in patients with cholelithiasis. International Journal of Applied and Basic Medical Research 7(3): 186. doi: 10.4103/2229-516X.212968.
Goodarzi R, Saedisomeolia A, Moghadam EF, Sadoogh-Abbasi A, Sianaki A, et al. (2017). Evaluation of the serum lipid profile and dietary intake in patients undergoing cholecystectomy. Advanced Studies in Biology 9: 171–179. doi: 10.12988/asb.2017.61140.
Haq AM, Giasuddin A (2016). Effect of cholecystectomy on lipid profile in Bangladeshi patients with cholelithiasis. Journal of Metabolic Syndrome 05(01). doi: 10.4172/2167-0943.1000192.
Hariyanto TI, Kurniawan A (2021). Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: A systematic review and meta-analysis. Sleep Medicine 82: 47–53. doi: 10.1016/j.sleep.2021.03.029.
Hayat S, Hassan Z, Changazi SH, Zahra A, Noman M, et al. (2019). Comparative analysis of serum lipid profiles in patients with and without gallstones: A prospective cross-sectional study. Annals of Medicine and Surgery 42: 11–13. doi: 10.1016/j.amsu.2019.04.003.
Ikram N, Babar SAA, Aslam T, Malik H, Zahid N, et al. (2020). Physiological effect of cholecystectomy on lipid profile of patients with cholelithiasis. International Journal of Scientific Reports 6(7): 243. doi: 10.18203/issn.2454-2156.IntJSciRep20202638.
Jain A, Singh MM, Choudhary P (2018). Effect of cholecystectomy on serum lipid profile. Global Journal for Research Analysis 7(4): 18–19. Retrieved from https://www.worldwidejournals.com/global-journal-for-research-analysis-GJRA/article/effect-of-cholecystectomy-on-serum-lipid-profile/ODgwMw==/?is=1.
Jindal N, Singh G, Ali I, Sali G, Reddy R (2013). Effect of cholelithiasis and cholecystectomy on serum lipids and blood glucose parameters. Archives of International Surgery 3(2): 97. doi: 10.4103/2278-9596.122926.
Karki O, Timilsina BD (2021). Effect of cholecystectomy on serum lipids and blood glucose (hospital based observational prospective study). Nepal Journal of Medical Sciences 6(1): 8–13. doi: 10.3126/njms.v6i1.36725.
Kenary AY, Notash AY, Nazari M, Notash AY, Borjian A, et al. (2012). Measuring the rate of weight gain and the influential role of diet in patients undergoing elective laparoscopic cholecystectomy: A 6-month follow-up study. International Journal of Food Sciences and Nutrition 63(6): 645–648. doi: 10.3109/09637486.2011.644767.
Kumar R, Singh V, Ahmad S, Singh M, Singh A, et al. (2020). Evaluation of changes in serum lipid profile and fasting blood glucose levels in patients with gall stone disease before and after cholecystectomy. International Surgery Journal 7(4): 1089. doi: 10.18203/2349-2902.isj20201012.
Menezes JVF, Katamreddy RR (2019). The effect of cholecystectomy on the lipid profile of patients with gallstone disease: A prospective study. International Surgery Journal 6(11): 4112. doi: 10.18203/2349-2902.isj20195133.
Moazeni-Bistgani M, Kheiri S, Ghorbanpour K (2014). The effects of cholecystectomy on serum lipids during one year follow-up. Research 1. doi: 10.13070/rs.en.1.1094.
Osman A, Ibrahim AH, Alzamil AM, Alkhalifa AM, Badghaish DA, et al. (2020). Is cholecystectomy in patients with symptomatic uncomplicated cholelithiasis beneficial in improving the lipid profile? Cureus. doi: 10.7759/cureus.6729.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ: n71. doi: 10.1136/bmj.n71.
Peters AEJ, Verspeek LB, Nieuwenhuijze M, Harskamp-van Ginkel MW, Meertens RM (2023). The relation between sleep quality during pregnancy and health-related quality of life—A systematic review. The Journal of Maternal-Fetal & Neonatal Medicine 36(1). doi: 10.1080/14767058.2023.2212829.
Podgórski PB, Przybyłkowski A, Nehring P (2023). Bile composition - Which components can have clinical significance? A review of the literature. Journal of Gastrointestinal and Liver Diseases 32(1): 110–117. doi: 10.15403/jgld-4634.
Preetha S, Rajkumar D, Prathap L (2020). Estimation of serum lipid profile in cholelithiasis patients. PalArch’s Journal of Archaeology of Egypt/Egyptology 17(7): 1747–1757. Retrieved from https://archives.palarch.nl/index.php/jae/article/view/1419.
Shuwelif AR, Mihson HS, Maikhan AK (2022). The effect of laparoscopic cholecystectomy on lipid profile. Mustansiriya Medical Journal 21(2): 151–154. doi: 10.4103/mj.mj_45_22.
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, et al. (2016). ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions. BMJ: i4919. doi: 10.1136/bmj.i4919.
The Cochrane Collaboration. 2020. Review Manager (RevMan) [computer program], version 5.4. Retrieved from https://test-training.cochrane.org/online-learning/core-software-cochrane-reviews/review-manager-revman/download-revman-5.
Wang SF, Wu CH, Sung KF, Tsou YK, Lin CH, et al. (2023). The impact of metabolic factors and lipid-lowering drugs on common bile duct stone recurrence after endoscopic sphincterotomy with following cholecystectomy. Journal of Personalized Medicine 13(10): 1490. doi: 10.3390/jpm13101490.
Yin H, Chen W, He X, Zeng J (2022). Changes of bile acids and resting energy expenditure after laparoscopic cholecystectomy in type 2 diabetes patients: A prospective study. Diabetology & Metabolic Syndrome 14(1): 108. doi: 10.1186/s13098-022-00880-3.
Zhao P, Liu S, Zhong Z, Liu J (2018). Age- and sex-related difference of lipid profile in patients with ischemic stroke in China. Medicine 97(23): e10930. doi: 10.1097/MD.0000000000010930.
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