EFFECT OF CHOLECYSTECTOMY ON LIPID AND BILE ACID METABOLISM: EVIDENCE FROM THE ORIGINAL STUDY
Abstract
Introduction. The prevalence of cholelithiasis shows a constant increase and reaches 15% in developed countries. The main method of its treatment remains cholecystectomy, which, according to researchers, is associated with adverse metabolic consequences Aim: to study the effect of cholecystectomy on the metabolism of lipids and bile acids in the blood plasma of patients with cholelithiasis. Materials and methods: 96 patients aged 22–45 years with cholelithiasis (gall bladder stones) who underwent elective laparoscopic cholecystectomy were divided into 2 groups according to the lipid profile of the blood plasma. Clinical data, questioning, lipidogram, chromato-mass spectrometry of bile acids in blood plasma and bile were used. After surgical treatment, half of the patients with changes in the lipid spectrum received ursodeoxycholic acid preparations for 3 months. Re-examination after 3 months and 1 year after cholecystectomy. Results. Lipidogram parameters in the groups differed statistically significantly. Plasma bile acid levels differed significantly for cholic and ursodeoxycholic acids. In the “Normal lipid spectrum” group, after 3 months, an improvement was observed, and after a year, a significant deterioration in lipidogram parameters. In the “Changes in the lipid spectrum” group, after 3 months, an improvement in lipidogram parameters was noted only in patients taking ursodeoxycholic acid. A year later, no statistically significant changes were found. Conclusions. In patients with cholelithiasis, there is an imbalance of fatty acids: an increase in the levels of cholic, deoxycholic, glycocholic, taurocholic acids, and a decrease in the level of chenodesoxycholic. UDCA levels in blood plasma and bile are directly correlated. After cholecystectomy in the blood plasma, the concentrations of elevated acids, as well as the initially reduced chenodesocholic acid, decrease. In patients with a normal blood lipid spectrum, cholecystectomy negatively affects the lipid profile. Cholecystectomy increases the risk of lipid spectrum deterioration by 1.6 times. Taking UDCA preparations improves the parameters of the blood lipid spectrum.
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