Bowel habit after cholecystectomy: physiological changes and clinical implications

Gastroenterology. 1996 Sep;111(3):617-22. doi: 10.1053/gast.1996.v111.pm8780565.


Background & aims: Scarce data suggest that cholecystectomy may alter bowel habit. The aim of this study was to determine whether cholecystectomy modifies gut transit.

Methods: Five experimental groups were studied: 29 patients with uncomplicated gallstones before and 1 month after elective cholecystectomy, 22 patients 4 years after elective cholecystectomy, 14 patients with postcholecystectomy diarrhea, 5 patients with acute infectious diarrhea (disease controls), and 13 patients before and 1 month after other elective surgery (surgical controls). All participants underwent measurement of colonic transit by a modified radiopaque pellet method and orocecal transit by the standard lactulose breath H2 test.

Results: One month postoperatively, cholecystectomy had substantially accelerated total colonic transit (51 +/- 5 hours before vs. 38 +/- 5 hours after; P < 0.05) and delayed slightly orocecal transit (80 +/- 4 minutes before vs. 103 +/- 8 minutes after; P = 0.05). Similar colonic and orocecal transit times were measured 4 years after cholecystectomy (40 +/- 4 hours and 105 +/- 8 minutes, respectively). Colonic transit times in patients with the postcholecystectomy diarrhea syndrome were accelerated as much as in patients with infectious diarrhea, who served as controls (19 +/- 3 hours and 15 +/- 4 hours, respectively). Surgery per se had no effect on gut transit.

Conclusions: Cholecystectomy shortens gut transit by accelerating colonic passage. These sequelae develop early and persist at least 4 years after cholecystectomy. The postcholecystectomy diarrhea syndrome probably represents a magnification of the above colonic sequelae.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholecystectomy / adverse effects*
  • Cholelithiasis / surgery
  • Colon / physiopathology
  • Defecation*
  • Diarrhea / etiology
  • Diarrhea / physiopathology
  • Female
  • Gastrointestinal Transit
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Postoperative Period
  • Prospective Studies
  • Retrospective Studies
  • Syndrome