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Cholecystectomy and oesophageal reflux: a prospective evaluation
S Jazrawi1, T N Walsh, P J Byrne
1University Department of Surgery, Trinity College, St James's Hospital, Dublin, Ireland.
The British Journal of Surgery
|January 1, 1993
Summary
Cholecystectomy significantly increases gastro-oesophageal reflux and gastritis. This occurs due to compromised lower oesophageal sphincter competence following gallbladder removal surgery.
Area of Science:
- Gastroenterology
- Digestive System Physiology
Background:
- Gallbladder removal surgery (cholecystectomy) is common.
- Potential post-surgical complications affecting the esophagus are not fully understood.
Purpose of the Study:
- To prospectively evaluate the impact of cholecystectomy on esophageal function.
- To investigate changes in gastro-oesophageal reflux and related parameters post-surgery.
Main Methods:
- Prospective study of 37 patients undergoing cholecystectomy.
- Assessment of esophageal pH profiles and DeMeester acid reflux scores.
- Evaluation of lower oesophageal sphincter function and gastric alkaline shift.
Main Results:
- 46% of patients remained symptomatic 3-4 months post-surgery.
- Abnormal esophageal pH profiles increased from 35% to 73% (P < 0.002).
- DeMeester scores significantly increased (P < 0.001), and sphincter function was reduced (P < 0.01).
- Gastric alkaline shift and gastritis incidence significantly rose (P < 0.02 and P < 0.001, respectively).
Conclusions:
- Cholecystectomy appears to induce gastro-oesophageal reflux.
- Compromised lower oesophageal sphincter competence may be the underlying mechanism.
- Increased reflux and gastritis are significant post-cholecystectomy complications.