Changes in Lipid Profile Six Months After Cholecystectomy for Gallstone Disease: A Prospective Before-After Study

Abstract

<ns3:p>Background The gallbladder plays an essential role in lipid homeostasis through bile storage and regulated release. Gallstone disease is frequently associated with dyslipidemia, and cholecystectomy is one of the most common abdominal surgeries worldwide. However, its influence on serum lipid metabolism remains incompletely understood. Objective To evaluate changes in serum lipid profiles six months after cholecystectomy and assess whether the procedure has any adverse effect on lipid metabolism. Methods A prospective, single-arm, before-after study was conducted on 40 adult patients undergoing laparoscopic cholecystectomy for symptomatic gallstone disease between August 2022 and March 2023. Fasting lipid profiles—including LDL-cholesterol, HDL-cholesterol, triglycerides, total cholesterol, and VLDL—were measured preoperatively and at 6-month follow-up. The Atherogenic Index of Plasma (AIP) and total cholesterol/HDL ratio were calculated. Statistical analysis was performed using paired tests with significance set at p &lt; 0.05. Results Statistically significant but small reductions were observed in total cholesterol (206.0 ± 37.1 to 194.8 ± 33.7 mg/dL, p = 0.003), LDL-cholesterol (128.7 ± 34.3 to 122.9 ± 31.6 mg/dL, p = 0.002), VLDL (25.2 ± 7.7 to 23.6 ± 7.8 mg/dL, p = 0.031), and the total cholesterol/HDL ratio (p = 0.004). HDL and triglyceride levels showed no significant change. AIP remained stable. The proportion of patients with dyslipidemia did not change substantively. Conclusions In this single-arm, before-after study, cholecystectomy was not associated with any adverse effect on the lipid profile six months postoperatively. Small statistically significant reductions in total cholesterol and LDL were observed, but their magnitude is well below that achievable with standard pharmacological or lifestyle interventions and is unlikely to be clinically meaningful in isolation. The principal message of this study is therefore one of reassurance: cholecystectomy for symptomatic gallstone disease did not worsen lipid metabolism in our cohort. Owing to the absence of a non-surgical control group and the presence of unmeasured confounders, these findings should be interpreted with caution and confirmed in larger, controlled studies.</ns3:p>