Cholecystectomy and non-alcoholic fatty liver disease: Exploring the hidden connection and implications

Cholecystectomy, one of the most common surgical procedures worldwide, is generally considered safe and effective. However, emerging evidence suggests a potential link between cholecystectomy and the development or progression of non-alcoholic fatty liver disease. This article examines the current understanding of this association, focusing on mechanisms such as altered bile acid metabolism, gut microbiota dysbiosis, and changes in lipid homeostasis. It addresses resolved challenges, including short-term metabolic effects, and highlights key unresolved questions, such as the long-term impact on liver health and specific at-risk populations. Finally, the review discusses future research directions and practical strategies for monitoring and managing liver health in patient's post-cholecystectomy, aiming to improve outcomes and guide clinical practice.