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Cholecystectomy Causes Ultrasound Evidence of Increased Hepatic Steatosis

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Abstract

Background

Cholecystectomy might contribute to the development of hepatic steatosis through metabolic changes. The biologic alteration of the enterohepatic circulation of bile acids and the alteration of the metabolic activity of bile acid that follows cholecystectomy may contribute to hepatic steatosis. This prospective study was conducted to clarify the possibility of steatosis development after cholecystectomy.

Methods

From October 2013 to July 2014, 82 consecutive patients with a presumptive diagnosis of gallbladder disease were cholecystectomized. Liver parenchymal steatosis was measured using ultrasound and the hepatic steatosis index.

Results

In all 82 patients, the hepatic steatosis index was found to be significantly correlated with the US fatty liver grade (Spearman’s correlation r 2 = 0.331, P < 0.001). A total of 62 patients were followed up for 3 months. Comparison with the initial grade showed that 12 (18.5 %) patients had worsened from normal to mild (n = 10), from mild to moderate (n = 1), and from mild to severe (n = 1). The other patients stayed at their initial grade except one patient who improved (from moderated to mild). Analysis of laboratory findings showed that white blood cell count, aspartate transaminase, alanine transaminase level, and total bilirubin level were decreased. However, serum albumin and high-density lipoprotein cholesterol levels significantly increased.

Conclusions

Hepatic steatosis significantly developed 3 months after cholecystectomy. Therefore, cholecystectomy might be considered a risk factor for hepatic steatosis, but the relationship should be confirmed with long-term follow-up from a large group of patients.

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Abbreviations

US:

Ultrasound

BMI:

Body mass index

WBC:

White blood cell

PLT:

Platelet

ALP:

Alkaline phosphatase

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

TG:

Triglyceride

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

CRP:

C-reactive protein

HSI:

Hepatic steatosis index

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Acknowledgments

This work was carried out with the support of “Cooperative Research Program for Agriculture Science & Technology Development (Project No. PJ011002022015)” Rural Development Administration, Republic of Korea. This work was registered to U.S. National Institutes of Health (Clinicaltrials.gov Identifier: NCT02493153).

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    Authors and Affiliations

    1. Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea

      Sangchul Yun

    2. Department of Surgery, Hanyang University College of Medicine, Seoul, Korea

      Dongho Choi, Kyeong Geun Lee & Han Joon Kim

    3. Department of Radiology, Hanyang University College of Medicine, Seoul, Korea

      Bo-Kyeong Kang

    4. Department of Pathology, Hanyang University College of Medicine, Seoul, Korea

      Hyunsung Kim & Seung Sam Paik

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    1. Sangchul Yun
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    Correspondence to Dongho Choi or Bo-Kyeong Kang.

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    Dongho Choi and Bo-Kyeong Kang equally contributed to this journal as corresponding author.

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    Yun, S., Choi, D., Lee, K.G. et al. Cholecystectomy Causes Ultrasound Evidence of Increased Hepatic Steatosis. World J Surg 40, 1412–1421 (2016). https://doi.org/10.1007/s00268-015-3396-7

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    • DOI: https://doi.org/10.1007/s00268-015-3396-7

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