Cholecystectomy as a risk factor for non-alcoholic fatty liver disease development

HPB (Oxford). 2020 Nov;22(11):1513-1520. doi: 10.1016/j.hpb.2020.07.011. Epub 2020 Aug 7.


Background: Hepatic steatosis and gallstone disease are highly prevalent in the general population; the shared risk factors are age, ethnicity, obesity, insulin resistance, metabolic syndrome, atherosclerosis, risk of cardiovascular disease, and mortality. The presence of insulin resistance is the critical element in this association because it represents a crucial link between metabolic syndrome and non-alcoholic fatty liver disease, as well as a higher susceptibility to gallstone formation.

Methods: An exhaustive search engine investigation of gallstone disease, cholecystectomy, and liver steatosis latest literature was made.

Results: Clinical studies and systematic reviews suggest an association between gallstone disease, cholecystectomy, and hepatic steatosis.

Conclusion: The bidirectional relationship between liver steatosis and gallstone disease and cholecystectomy is summarized in the role of insulin resistance, lipid metabolism, bile acids signaling pathways regulated by transcription factors expression, and to the gallbladder physiological role; however, more epidemiological and experimental studies should be complemented.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cholecystectomy
  • Gallstones* / epidemiology
  • Gallstones* / surgery
  • Humans
  • Insulin Resistance*
  • Liver
  • Non-alcoholic Fatty Liver Disease* / diagnosis
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Risk Factors