The role of cholelithiasis and cholecystectomy in the prognosis of non-alcoholic fatty liver disease: Recommendations for patient management

There is a close connection between cholelithiasis (GSD) and non-alcoholic fatty liver disease (NAFLD). It is based on common risk factors, insulin resistance, disorders of carbohydrate and lipid metabolism, hepato-enteric circulation (HEC) of bile acids and the state of intestinal microflora. Chole-cystectomy (CE) is currently considered as an independent risk factor for the development and progres-sion of NAFLD and metabolic disorders in patients with cholelithiasis.

That is why a patient suffering from cholelithiasis and NAFLD needs an individual approach before cholecystectomy. Patients with cholelithiasis and NAFLD are recommended to undergo a dynamic monitoring after cholecystectomy. The monitoring includes a control of general condition, biochemical parameters of the liver, lipid and carbohydrate metabolism, liver fibroelastography parameters. The treatment for this category of patients is aimed at eliminating risk factors, strict adherence to diet, phys-ical activity regimen, in order to correct obesity, dyslipidemia, hyperglycemia, the use of drugs that im-prove the condition of the hepatocytes, lipid and carbohydrate metabolism, the metabolic function of hepatocytes and inhibiting the processes of fibrogenesis in liver. At the same time, the common medi-cines of this category of patients are ursodeoxycholic acid, glycyrrhizic acid, phospholipids, antioxi-dants, and drugs to cure bacterial overgrowth syndrome in the intestines.

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