Effect of cholecystectomy on liver fat and fibrosis in metabolic dysfunction-associated steatotic liver disease patients

doi:10.4292/wjgpt.v17.i2.114876

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 2

This Article

(0) (0) (0) (2)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Pharmacology and Therapeutics

ISSN

2150-5349

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Pharmacol Ther. Jun 5, 2026; 17(2): 114876
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.114876

Effect of cholecystectomy on liver fat and fibrosis in metabolic dysfunction-associated steatotic liver disease patients

Khellaf Amalou, Nassila Belal, Abdelghani Tibouk, Yasmine Ghedada, Rym Rekab, Sabrina Fadel, Nabil Debzi, Abderezak Bousloub

Khellaf Amalou, Rym Rekab, Sabrina Fadel, Abderezak Bousloub, Department of Gastroenterology, Mohamed Seghir Nekkache, Algiers 16000, Algeria

Nassila Belal, Department of Radiology, Mohamed Seghir Nekkache, Algiers 16000, Algeria

Abdelghani Tibouk, Department of Pathology, Mohamed Seghir Nekkache, Algiers 16000, Algeria

Yasmine Ghedada, Department of Biology, Mohamed Seghir Nekkache, Algiers 16000, Algeria

Nabil Debzi, Department of Gastroenterology, CHU Mustafa, Algiers 16000, Algeria

Author contributions: Amalou K is the main contributor to the manuscript and the first author; Amalou K contributed to making significant, original, and insightful intellectual contributions; participated in the conception or planning of the research; obtaining manuscript data by conducting experiments; performing literature reviews, or carrying out surveys or interviews; analyzing the findings of the manuscript through statistical analysis and preparing figures and/or tables; planning and writing the manuscript; and participating in responding to reviewers’ comments and manuscript revision after manuscript submission; Belal N, Tibouk A, Ghedada Y, Rekab R, Fadel S, Debzi N, Bousloub A are first and foremost responsible for the finalization of the content of the parts that they completed or participated in. In particular, the other authors contributed to verifying the content of the parts involving them in each iteration of the revised manuscript, verifying their name and initials, verifying their affiliations; and verifying the PDF full text, figures, tables, and references in the manuscript. All authors have read and approved the final manuscript.

Institutional review board statement: The study protocol has been reviewed and approved by Hôpital Mohamed Seghir Nekkache.

Clinical trial registration statement: This study is registered in the Pan African Clinical Trials Registry, with the registration number: PACTR202511511917109.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: Data are available from the corresponding author.

Corresponding author: Khellaf Amalou, PhD, Assistant Professor, Department of Gastroenterology, Mohamed Seghir Nekkache, Kouba 246, Algiers 16000, Algeria. amalou_kh@yahoo.fr

Received: October 1, 2025
Revised: December 2, 2025
Accepted: February 3, 2026
Published online: June 5, 2026
Processing time: 238 Days and 9.8 Hours

Abstract

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent worldwide. Experimental studies have shown that cholecystectomy (Chx) increases metabolic dysfunction-associated steatotic liver (MASL) and is associated with MASLD in large retrospective cohort studies.

AIM

To prospectively evaluate the effect of Chx on MASL and fibrosis, assess the prevalence of MASLD, and identify its risk factors in this population.

METHODS

There were 213 MASLD patients enrolled, with 103 being Chx and 110 being non-Chx patients. The patients were followed up for 36 months.

RESULTS

Body mass index increased in the Chx group (30.15 ± 4.08 to 31.58 ± 4.64) vs (31.90 ± 4.07 to 30.03 ± 4.16) in the control group (P < 0.001). Median controlled attenuation parameter increased from 300.77 ± 47.42 to 314.17 ± 44.7 (Chx) and decreased from 325.06 ± 41.74 to 296.36 ± 56.51 (control) (P < 0.01). MASL/magnetic resonance imaging (MRI) moved from 14.22 ± 8.64 and 18.55 ± 8.57 at baseline to 15.98 ± 7.93 and 13.88 ± 8.12 at the end of the study (P < 0.001). The biological scores of MASL (fatty liver index, hepatic steatosis index, and lipid accumulation product) all progressed in the Chx group and regressed in the control group (P < 0.001). The prevalence of hepatic steatosis was 42.38% (Chx). Risk factors associated with significant hepatic steatosis were metabolic syndrome, Chx, MASL/MRI, and fatty liver index scores. Risk factors associated with advanced fibrosis are body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes mellitus score, stiffness, and Chx. Stiffness, obesity, Chx, gamma-glutamyl transferase, and MASL/MRI are associated with metabolic dysfunction-associated steatohepatitis (MASH) lesions.

CONCLUSION

Chx increases MASL and fibrosis. MASLD prevalence in the Chx group is higher than in the overall population.

Keywords: Metabolic dysfunction-associated steatotic liver disease; Cholecystectomy; Hepatic fibrosis; Metabolic dysfunction-associated steatotic liver; Metabolic dysfunction-associated steatohepatitis

Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most common chronic liver disease. It is significantly linked to diabetes, obesity, and other cardiometabolic risk factors. It is more pronounced in cholecystectomized patients than in those with lithiasis. Recent research suggests that the gallbladder may help to maintain overall metabolic homeostasis. Recent data suggests that cholecystectomy (Chx) has metabolic effects and may operate as a risk factor for MASLD and metabolic syndrome. In our study, we found that Chx enhances metabolic dysfunction-associated steatotic liver and fibrosis. MASLD prevalence is higher in the Chx group than in the general population.