Cholecystectomy and oesophageal reflux: A prospective evaluation

The effect of cholecystectomy on oesophageal function was examined prospectively. Of 37 patients studied, 17 (46 per cent) were still symptomatic 3–4 months after surgery. Thirteen patients (35 per cent) had abnormal oesophageal pH profiles before cholecystectomy, increasing to 27(73 per cent) afterwards(P < 0·002). The mean(s.e.m.) DeMeester acid reflux score increased from 15·2(2·1) to 34·2(5·2) (P < 0·001) after operation. Lower oesophageal sphincter function, as measured by the sphincter function index, was significantly reduced in the patients with abnormal pH profiles after operation (P < 0·01). Mean(s.e.m.) supine gastric alkaline shift (proportion of time at pH > 4) increased from 9·2(2·0) to 17·7(3·7) per cent (P < 0·02) and the incidence of gastritis from eight patients (22 per cent) to 23 (62 per cent) (P < 0·001). These data suggest that cholecystectomy results in gastro-oesophageal reflux that appears to be related to compromised sphincter competence.