Dr Otto Lin and colleagues performed a large controlled prospective observational study to compare pre- and postsurgery changes in reflux symptoms between cholecystectomy and hernia repair surgery patients.

The team identified 6 studies suggesting that gastroesophageal reflux worsens after cholecystectomy, however, all these studies had design limitations.

The team recruited 302 patients scheduled to undergo elective cholecystectomy or hernia repair at 2 hospitals. 

Both groups filled out the validated reflux symptom score and gastrointestinal symptom rating scale questionnaires 1 to 15 days prior to and 4 to 12 weeks after the operation.

Changes in symptom scores between the pre and postsurgery assessments were measured, and compared between the 2 groups.

The researchers found that baseline reflux symptom score and gastrointestinal symptom rating scale reflux subscores were higher in the study group than controls.

There were no significant differences in any of the symptom score changes between the 2 groups except for the gastrointestinal symptom rating scale pain subscore, which decreased more in the study group than the control group.

The team found with regard to reflux, the reflux symptom score decreased by 0.3 in the study group and 0.1 in controls.

While the gastrointestinal symptom rating scale reflux subscore decreased by 0.3 in the study group, and by 0.05 in controls. 

Gastrointestinal symptom rating scale diarrhea and constipation subscores decreased slightly after surgery, to the same extent in both groups.

Dr Lin's team concluded, “This large prospective controlled study, the only one using validated reflux symptom questionnaires, shows that cholecystectomy does not lead to an increase in reflux symptoms.” 

“As expected, Gastrointestinal Symptom Rating Scale pain subscores were decreased in the cholecystectomy group but not the controls.”