The Post-Cholecystectomy Gut Microbiota Follows a Time-Varying Change-A Pilot Study.

Area of Science:

• Gastroenterology
• Microbiology
• Surgery

Background:

• Gut microbiota plays a key role in post-cholecystectomy diarrhea (PCD).
• PCD symptoms decrease over time, indicating a time-dependent microbiota shift.
• Understanding these temporal changes is crucial for managing PCD.

Purpose of the Study:

• To analyze gut microbiota composition and diversity at different time points after cholecystectomy.
• To clarify the time-varying features of gut microbiota in relation to PCD.
• To investigate the relationship between specific microbial taxa and PCD development.

Main Methods:

• Prospective recruitment of patients aged 20-70 undergoing laparoscopic cholecystectomy.
• Exclusion of subjects with prior abdominal surgery, systemic diseases, or recent antibiotic/probiotic/PPI use.
• Stool sample analysis at baseline, 6 months, and 12 months post-surgery using R phyloseq, LEfSe, and metagenomeSeq.

Main Results:

• Microbial diversity was significantly lower at 6 months post-surgery (p=0.036/0.002).
• Distinct changes in bacterial taxa were observed, including increased *Fusobacterium* and *Prevotella*, and altered *Lactobacillus*/*Ruminococcus* levels.
• A decreased *Firmicutes*/*Bacteroidetes* ratio at 6 months suggests mechanisms distinct from irritable bowel syndrome.

Conclusions:

• The study demonstrates time-varying trends in gut microbial diversity and composition following cholecystectomy.
• Observed microbial shifts are linked to post-cholecystectomy diarrhea.
• Larger studies are required to validate these time-dependent findings.