Published: 2020-06-23

Physiological effect of cholecystectomy on lipid profile of patients with cholelithiasis

Naila Ikram, Shehzada A. A. Babar, Tahir Aslam, Hira Malik, Natasha Zahid, Anas Bin Tariq


Background: The association of cholecystectomy with alterations in lipid profile is well documented. Objectives of this study were to determine the effect of cholecystectomy on lipid profile of cholelithiasis patients.

Methods: This cross-sectional observational study was done on 170 patients admitted in general surgery department of Naz Memorial Hospital, Karachi from July 2018 to June 2019. Symptomatic cholelithaisis patients between 18 to 60 years, elective cholecystectomy was included while patients previously on lipid lowering agents, diagnosed renal failure, nephrotic syndrome, cardiac failure, pregnant mothers, hypothyroidism, pancreatitis and obstructive jaundice were excluded. For data analysis, SPSS was used. Wilcoxon signed ranked test was used to compare mean values of pre and post-operative lipid profiles after cholecystectomy keeping p value of <0.05 as significant.  

Results: 60% of patients were females with majority, 31% patients between 31-40 years while least, i.e. 11% were between 61-70 years. The mean pre-operative and post-operative difference of 52±7.32 mg/dl was seen in total cholesterol levels (p<0.001). The mean difference in high density lipoprotein (HDL) between pre and post-operative was of 13±0.36 mg/dl (p<0.001). The mean difference in low density lipoprotein (LDL) between pre- and post-operative was 61±10.45 mg/dl (p<0.001). The mean difference in triglycerides levels between pre- and post-operative was 46±25.49 mg/dl (p<0.001).

Conclusions: Cholecystectomy in gall stone disease patients elicited favorable response in significantly lowering levels of total serum cholesterol, LDL and triglycerides while substantially increasing levels of HDL cholesterol.



Lipid profile, Cholecystectomy, Cholelithiaisis, HDL, LDL, Triglycerides

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Ciaula DA, Wang DQ, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Current Opinion Gastroenterol. 2018;34(2):71-80.

Pak M, Lindseth G. Risk factors for cholelithiasis. Gastroenterology Nursing. 2016;39(4):297-309.

Bonfrate L, Wang DQ, Garruti G, Portincasa P. Obesity and the risk and prognosis of gallstone disease and pancreatitis. Best Practice Res Clin Gastroenterol. 2014;28(4):623-35.

Shabanzadeh DM. Incidence of gallstone disease and complications. Current Opinion Gastroenterol. 2018;34(2):81-9.

Talseth A, Jensen NE, Edna TH, Hveem K. Risk factors for requiring cholecystectomy for gallstone disease in a prospective population‐based cohort study. Br J Surg. 2016;103(10):1350-7.

Lv J, Qi L, Yu C, Guo Y, Bian Z, Chen Y, et al. Gallstone disease and the risk of ischemic heart disease. Arteriosclerosis Thrombosis Vascular Biol. 2015;35(10):2232-7.

Chen Y, Kong J, Wu S. Cholesterol gallstone disease: focusing on the role of gallbladder. Lab Investigat. 2015;95(2):124-31.

Karki OB. Effect of cholecystectomy on fasting lipid profile and blood glucose. J Society Surg Nepal. 2015;18(3):19.

Singh DP. Assessment of serum lipid profile in patients undergoing laparoscopic cholecystectomy. Int J Surg. 2019;3(3):212-4.

Atamanalp RS. Is there a relationship between the serum cholesterol level and the biochemical structure of gallstone in patients with cholelithiasis. IB Extended Essay. 2012:1-20.

Atamanalp SS, Keles MS, Atamanalp RS, Acemoglu H, Laloglu E. The effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. Pakistan J Med Sci. 2013;29(1):187-90.

Ciaula DA, Wang DQ, Portincasa P. Cholesterol cholelithiasis: part of a systemic metabolic disease, prone to primary prevention. Expert Review Gastroenterology Hepatology. 2019;13(2):157-71.

Chen Y, Kong J, Wu S. Cholesterol gallstone disease: focusing on the role of gallbladder. Laboratory Investigation. 2015;95(2):124-31.

Weerakoon HT, Ranasinghe S, Navaratne A, Sivakanesan R, Galketiya KB, Rosairo S. Serum lipid concentrations in patients with cholesterol and pigment gallstones. BMC Res Notes. 2014;7(1):548-53.

Pak M, Lindseth G. Risk factors for cholelithiasis. Gastroenterology Nursing. 2016;39(4):297-309.

Rasheed RA. Lipid profile and hematological changes in gallstone patients. Sci J University Zakho. 2014;2(1):49-53.

Norlin M, Wikvall K. Enzymes in the conversion of cholesterol into bile acids. Current Molecular Med. 2007;7(2):199-218.

Chiang JY. Bile acid metabolism and signalling. Comprehensive Physiology. 2013;3(3):1191-212.

Harish B. A cross sectional study on causes and risk factors of gallstone disease among patients with symptomatic Cholilithiasis. Int J Nursing Res Practice. 2014;1(1):20-4.

Malik AA, Wani ML, Tak SI, Irshad I, Hassan UN. Association of dyslipidaemia with cholilithiasis and effect of cholecystectomy on the same. Int J Surg. 2011;9(8):641-2.

Jindal N, Singh G, Ali I, Sali G, Reddy R. Effect of cholelithiasis and cholecystectomy on serum lipids and blood glucose parameters. Archives Int Surg. 2013;3(2):97-101.

Kataan AMA, Bashi AY, Khyatt AMK. Some serum lipid profile and glucose levels pre-and post-cholecystectomy. J Bahrain Med Society. 2010;22(1):18-22.

Ahi KS, Singh RP, Kaur H, Moudgil A. Serum lipid profile in pre and post cholecystectomy patients. Int J Anatomy Radiol Surg. 2017;6(2):1-6.

Singh RR, Adhikari SC, Bastakoti R, Regmi S, Baskota R, Giri K. Determining relation between gallstone and lipid profile. Birat J Health Sci. 2018;3(2):418-22.

Singletary BK, Thiel VDH, Eagon PK. Estrogen and progesterone receptors in human gallbladder. Hepatology. 1986;6(4):574-8.

Erpecum VKJ. Pathogenesis of cholesterol and pigment gallstones: an update. Clinics Research Hepatology Gastroenterology. 2011;35(4):281-7.

Rao PJ, Jarari A, Awami EH, Patil TN, Saiety ESO. Lipid profile in bile and serum of cholelithiasis patients: a comparative study. J Basic Med Allied Sci. 2012;1:27-39.

Channa NA, Ghanghro AB, Soomro AM. Quantitative analysis of serum lipid profile in gallstone patients and controls. Pakistan J Analytical Environ Chem. 2010;11(1):7-13.

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-87.

Haq AM, Giasuddin AS, Jhuma KA, Choudhury MA. Effect of cholecystectomy on lipid profile in Bangladeshi patients with cholelithiasis. J Metabol Syndrome. 2016;5(1):1-4.

Saha R, Bhattacharyya S, Ghosh S. A Cross Sectional Study on the Pattern and Association of Hyperlipidaemia in Patients with Cholelithiasis. J Evolution Med Dent Sci. 2019;8(36):2807-13.

Aljubori HH, Alobaidi AH, Fadhil B. Serum Lipids and Fasting Glucose Levels in Patients with Cholelithiasis. Middle East J Internal Med. 2012;63(276):1-5.

Goodarzi R, Saedisomeolia A, Moghadam EF, Abbasi SA, Sianaki A, Seaf Z. Evaluation of the Serum Lipid Profile and Dietary Intake in Patients Undergoing Cholecystectomy. Advanced Studies Biology. 2017;9(4):171-9.

Helvaci MR, Davarci M, Ozkan OV, Semerci E, Abyad A, Pocock L. Cholelithiasis and cholecystectomy may lower the low-density lipoprotein cholesterol in plasma. World Family Med J Incorporating Middle East J Family Med. 2017;99(5489):1-5.

Shiina Y, Toyoda T, Kawasoe Y, Tateno S, Shirai T, Matsuo K, et al. The prevalence and risk factors for cholelithiasis and asymptomatic gallstones in adults with congenital heart disease. Int J Cardiol. 2011;152(2):171-6.