The gallbladder and vermiform appendix influence the assemblage of intestinal microorganisms

Area of Science:

• Gastroenterology
• Microbiology
• Surgical Outcomes

Background:

• Surgical removal of the gallbladder (cholecystectomy) and appendix (appendectomy) is linked to altered intestinal microbiome composition.
• These alterations may contribute to gut dysbiosis and an increased risk of various diseases.
• Mechanisms involve changes in bile acid profiles and loss of the appendix's role in microbial recolonization.

Purpose of the Study:

• To review the scientific literature on the impact of cholecystectomy and appendectomy on the intestinal microbiome.
• To elucidate the roles of bile salts and the appendix in maintaining gut microbial homeostasis.
• To explore the association between these surgical procedures, gut dysbiosis, and subsequent disease risk.

Main Methods:

• Narrative review of existing epidemiological and scientific studies.
• Analysis of research investigating the bidirectional interactions between bile acids and gut microbiota.
• Examination of studies on the appendix's contribution to the colonic microbiome.

Main Results:

• Cholecystectomy alters bile acid composition and secretion, affecting microbial communities.
• Appendectomy removes a potential source for recolonization of the proximal colon with beneficial microbes.
• Epidemiological data suggest an increased disease risk post-surgery, though causality is complex.

Conclusions:

• Gallbladder and appendix removal can significantly impact the intestinal microbiome's structure and function.
• Bile acids and the appendix play crucial roles in maintaining a stable and healthy gut microbiota.
• Further research is needed to fully understand the long-term health consequences and causal links between these surgeries and disease development.