Effect of Cholecystectomy on Bubble Formation and Endoscopic Visualization: A Retrospective Cohort Study.

Abstract

Purpose: This study aimed to evaluate the association between cholecystectomy and colonic bubble formation during colonoscopy, METHODS: A single-center retrospective cohort study was conducted at Staten Island University Hospital. Researchers reviewed 348 colonoscopy reports, comparing patients with (n = 56) and without (n = 292) a history of cholecystectomy. Colonic bubble formation was assessed using a 0-3 scale (0 = no bubbles, 3 = severe bubbles). Secondary endpoints included polyp and adenoma detection, withdrawal and procedure times, bowel preparation quality, and repeat procedures. Statistical analysis included t-tests, Mann-Whitney U tests, and χ² tests.

Results: Patients with prior cholecystectomy had significantly higher incidence of severe bubble formation (score 3; 28.6% vs. 12%, p = 0.001), longer withdrawal times (18 ± 8 vs. 15 ± 5 min, p = 0.024), and increased need for repeat colonoscopies (10.7% vs. 2.1%, p = 0.001). No significant differences were found in adenoma detection, polyp detection, or bowel preparation quality between the two groups.

Conclusion: Cholecystectomy is associated with increased colonic bubble formation during colonoscopy, leading to longer withdrawal times and higher rates of repeat procedures. While this study did not find a difference in adenoma detection rates, the impaired visualization caused by bubbles may necessitate tailored bowel preparation strategies for patients with a history of cholecystectomy to optimize colonoscopy effectiveness.