Effect of Laparoscopic Cholecystectomy on 25- Hydroxyvitamin D Levels and Bone Mineral Density in Post Menopausal Women

Abstract

Background Laparoscopic cholecystectomy (LC) is the gold standard management for benign gallbladder diseases. It has been observed that there is alteration in vitamin D levels and bone mineral density after cholecystectomy due to altered enterohepatic circulation.With increase in average age expectancy of the population, low levels of vitamin D levels and osteoporosis after cholecystectomies might cause increased health care burden.

Methods A prospective observational study was planned between 1^st Jan 2022 to 30^th Jun 2023 in the Department of General Surgery at PGIMER Chandigarh, a tertiary care hospital in north India. One hundred and three post-menopausal women who underwent LC and met the inclusion and exclusion criteria were included in the study. All participants underwent estimation of vitamin D and bone mineral density preoperatively and 3^rdpost operative month (POM).

Results The mean age of the patients was58.46 ± 7.44. Pain abdomen was present in 68(66%) patients, 18 had epigastric discomfort and 17 had dyspepsia. The mean levels of vit D decreased from21.92 at the baseline to 20.12 at 3^rd POM(P < 0.001). There was significant change in t score Femoral Neck (-1.12 vs -1.15, P < 0.001) andLumbar spine L1-L4 -1.98 vs-1.98 (P = 0.033). z-Scores of the Femoral Neck were -0.34 vs -0.54 (p < 0.001) and of Lumbar spine L1-L4 were -0.95 vs 1.02 (P < 0.001). The decrease in fracture risk for the femoral neck(p= 0.344) and the lumbar spine (P = 0.223) were not statistically significant.

Conclusion There is significant decrease in vitamin D and BMD level after LC in post-menopausal females.

Key words:

• Laparoscopic cholecystectomy
• Bone mineral density
• Vitamin D3
• Gall stone disease
• Dual energy x-ray absorptiometry

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