胆囊切除术后患者肠道微生物群改变的研究进展

Advances in research related to gut microbiota in patients after cholecystectomy

目的总结胆囊切除术后肠道微生物群的变化、变化机制及与胆囊切除术后结直肠癌、非酒精性脂肪性肝脏疾病和胆囊切除术后综合征的关系,以期为胆囊切除术患者的围术期管理提供新思路。方法检索国内外有关胆囊切除术后肠道微生物群相关的研究并进行综述。结果胆囊切除术破坏了患者的肝脏-胆汁酸-肠道菌群轴,患者肠道微生物群的组成及多样性发生改变,这种改变可能导致结直肠癌、非酒精性脂肪性肝脏疾病、胆囊切除术后综合征等的发生,但具体机制仍不清楚。结论胆囊切除术后肠道微生态的平衡被打破,胆囊切除术与肠道微生物群的关系可能为胆囊切除术患者围术期的管理、胆囊切除术后疾病或症状的预防及治疗提供新思路,但胆囊切除术对肠道微生物群的影响以及与疾病或症状的关系仍需进一步研究。

Objective To summarize the changes of gut microbiota after cholecystectomy,the mechanisms of changes,and the relation with colorectal cancer,nonalcoholic fatty liver disease and post-cholecystectomy syndrome after cholecystectomy,in order to provide new ideas for the perioperative management of patients undergoing cholecystectomy.Method The studies related to gut microbiota after cholecystectomy at home and abroad were searched and analyzed for review.Results The cholecystectomy disrupted the liver–bile acid–gut flora axis of the patients,and the composition and diversity of the gut microbiota of the patients were altered,and the alteration might lead to the occurrence of colorectal cancer,nonalcoholic fatty liver disease,and post-cholecystectomy syndrome,but the exact mechanism remained unclear.Conclusions The balance of intestinal microecology is disrupted after cholecystectomy,and the relation between cholecystectomy and gut microbiota may provide new ideas for the perioperative management of cholecystectomy patients and the prevention and treatment of diseases or symptoms after cholecystectomy,but the effect of cholecystectomy on gut microbiota and the relation with diseases or symptoms still need to be further studied.