Bile acid diarrhoea and metabolic changes after cholecystectomy: a prospective case-control study.
Humans
Case-Control Studies
Diarrhea
/ etiology
Prospective Studies
Bile Acids and Salts
/ blood
Female
Male
Middle Aged
Fibroblast Growth Factors
/ blood
PPAR alpha
/ metabolism
Adult
Triglycerides
/ blood
Cholecystectomy
/ adverse effects
Gallbladder
/ metabolism
Postoperative Complications
/ etiology
Enterohepatic Circulation
Aged
Cholestenones
/ blood
Bile acids
Cholecystectomy
Diarrhoea
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
22 Aug 2024
22 Aug 2024
Historique:
received:
25
11
2023
accepted:
12
08
2024
medline:
23
8
2024
pubmed:
23
8
2024
entrez:
22
8
2024
Statut:
epublish
Résumé
Bile acid diarrhoea (BAD) can occur due to disruption to the enterohepatic circulation such as following cholecystectomy. However, the mechanism behind this is as yet unknown. The aim of this study was to determine the rate of post-cholecystectomy diarrhoea and to assess whether FGF19 within the gallbladder was associated with the development of BAD. This was a prospective case-control study in which patients were assessed pre- and post- cholecystectomy (study group) and compared with patients also having laparoscopic surgery but not cholecystectomy (control group). Their bowel habits and a GIQLI questionnaire was performed to compare the pre- and post-operative condition of the two groups. Gallbladder tissue sample was tested for FGF19 and PPARα in the study group patients. A subset had serum lipid levels, FGF19 and C4 measurements. Gallbladder PPAR α was found to have a significant correlation with stool consistency, with the lower the PPARα concentration the higher the Bristol stool chart number (i.e. looser stool). There were no significant correlation when assessing the effect of gallbladder FGF19 concentration on bowel habit, stool consistency, lipid levels, BMI or smoking. The study group showed a significant increase in triglycerides post-operatively, however there were no changes in cholesterol, HDL and LDL levels. Correlation of the increased triglyceride levels with stool consistency and frequency showed no significant results DISCUSSION AND CONCLUSION: We did not find any direct evidence that FGF19 levels within the gallbladder impact the development of post-cholecystectomy diarrhoea. There was however a significant increase in triglycerides postoperatively. There was also no correlation of bowel habits with PPARα suggesting the observed rise is independent of this pathway. Further work is required particularly relating to the gut microbiome to further investigate this condition.
Identifiants
pubmed: 39174936
doi: 10.1186/s12876-024-03368-8
pii: 10.1186/s12876-024-03368-8
doi:
Substances chimiques
Bile Acids and Salts
0
FGF19 protein, human
0
Fibroblast Growth Factors
62031-54-3
PPAR alpha
0
Triglycerides
0
Cholestenones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
282Informations de copyright
© 2024. The Author(s).
Références
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