Effect of Cholecystectomy on Serum Lipid Profile

Dr Amita Jain; Dr Madhav Madhusudan Singh; Dr Pranav Choudhary

Volume : VII, Issue : IV, April - 2018

Effect of Cholecystectomy on Serum Lipid Profile

Dr Amita Jain, Dr Madhav Madhusudan Singh, Dr Pranav Choudhary

Abstract :

Introduction: Gallstones have become a major health problem because of their silent manifestation and unclear pathogenesis. Cholelithiasis (gallstone disease) is one of the most common gastrointestinal disorders being prevalent in about 10-15% of adults in the developing countries .In a review of worldwide incidence, the female-to-male ratio was reported between 2 and 3. Although the association between the disturbed lipid metabolism and formation of gallstones has been elucidated in many studies, the effect of cholecystectomy on lipid profile has not been studied in detail. Based on evidence more than 50% of patients with gallstones have some sort of lipid disorder¹. It is now widely accepted that the primary event in the pathogenesis of cholesterol gallstones is an altered lipid metabolism, because of which there is a relative increase in the cholesterol levels compared to other lipids secreted by the liver into the bile .Cholecystectomy causes redistribution of bile acid pool in the entero-hepatic circulation and increases the frequency of cycling cause reduction in pool size thus exerting effect on lipid profile decreasing total cholesterol and LDL cholesterol levels².Women are twice as likely as men to form gallstones. Most common gallstone type found is mixed type and least is cholesterol type. Age group most commonly affected is between 31-50 years. There is a statistically significant association between high BMI and occurrence of gallstone. There is a statistically significant association between diabetes and occurrence of gallstone. No association has been found with parity, use of OCP, occupation, smoking, alcoholism in patients with cholelithiasis³.

Aim: Evaluating lipid profile of patients with gall stone pre- and post operatively on 7th day and 12 month and to establish the effect of cholecystectomy on lipid profile.

Objective :To determine the changes in lipid profile parameters after cholecystectomy

Materials and Methods: This prospective observational study included 50 patients of gall stones admitted to Surgery Department of multispecialty govt Hospital atMeerut from for duration of 1 years from Jan 2017 to Dec 2017 and who underwent cholecystectomy. The lipid profile was evaluated pre-operatively on the day of operation and post operatively on 7th day and 12 mth month after.

Results: This is a quasi-experimental study, carried out on 50 patients who were admitted to our hospital for elective laparoscopic cholecystectomy surgery during a period of 12 months from Jan 2017 to Dec 2017. Blood samples were collected from all of the study subjects prior to surgery, and again six month after the procedure.Serum was separated by centrifugation and total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. The data were analyzed using ANOVA with repeated measures in SPSS (17) software. The total serum cholesterol and LDL levels were significantly decreased one year after the surgery (P = 0.007)expect HDL, were significant differences compared to the pre-surgery values after one year (P = <0. 033). However, a significant decrease in TG levels was observed during the study (P ≤ 0.001).

Conclusion: Total serum lipids, serum cholesterol, serum LDL cholesterol and serum triglycerides levels decrease and serum HDL cholesterol increase after cholecystectomy.