Ultrasonographic assessment of the effects of cholelithiasis and cholecystectomy on gastric emptying: a prospective observational cohort study

Background Cholelithiasis is a prevalent biliary tract disorder, and cholecystectomy serves as a primary treatment modality. However, the impact of cholelithiasis and cholecystectomy on gastric emptying remains unclear. Ultrasound is a user-friendly, non-invasive measurement tool. The study aims to assess the effects of cholelithiasis and cholecystectomy on gastric emptying by ultrasonically measuring the cross-sectional area (CSA) of the gastric antrum. Methods Patients (n = 100) were divided into the cholelithiasis (CH) group, post-cholecystectomy (PC) group and healthy volunteer (HV) group (n = 30 each). The participants underwent an assessment of dyspepsia scores over the past nearly 3 months and drank a semi-solid test meal (300 kcal) after fasting. The following gastric emptying parameters were quantified ultrasonographically by the cross-sectional area (CSA) of the gastric antrum at baseline (T0) and at 5, 15, 30, 45, 60, 90, and 120 min after meal ingestion (T1 to T7): gastric emptying fractions at T5, T6, and T7, as well as the gastric half-emptying time. Results Compared with the HV group, both the CH and PC groups showed a significant increase in CSA from T3 to T7 (P < 0.05), and the CSA of the PC group from T4 to T7 was larger compared with the CH group (P < 0.05). Compared with the HV group, both the CH and PC groups exhibited significantly higher dyspepsia scores and impaired gastric emptying, as evidenced by lower gastric emptying fractions at T5, T6, and T7, and a prolonged gastric half-emptying time (P < 0.05). There was no significant difference in the dyspepsia scores between the CH group and the PC group. However, compared with the CH group, the PC group exhibited significantly lower gastric emptying fractions at T5 T6, and T7, as well as a longer gastric half-emptying time (P < 0.05). Conclusion Ultrasound assessment showed that compared with healthy volunteers, both patients with cholelithiasis and those after cholecystectomy had longer gastric emptying times, with the delay being more significant in the latter. Trial registration: www.chictr.org.cn (20/09/2022 ChiCTR2200063900)