Impact of concomitant cholecystectomy during gastrectomy for gastric cancer on the postoperative quality of life

This study aimed to evaluate the impact of concomitant prophylactic cholecystectomy during gastrectomy for gastric cancer on the postoperative quality of life (QOL) and nutritional outcomes. A retrospective analysis was conducted on 318 patients who underwent curative gastrectomy for gastric cancer between 2010 and 2023. Twenty-eight patients underwent prophylactic cholecystectomy, while 290 underwent gastrectomy alone. The postoperative QOL at one year was assessed using the Postgastrectomy Syndrome Assessment Scale-45, and the nutritional status was evaluated using body weight change. The operative time was significantly longer in the cholecystectomy group. However, blood loss and major complications were comparable. There was no significant difference between the two groups in the postoperative cholelithiasis-free rate or cholecystitis/cholangitis-free rate. One year postoperatively, the body weight loss was similar; however, diarrhea-related symptom scores were significantly higher in the cholecystectomy group (3.0 vs. 1.7, p = 0.01). A multivariate analysis identified male sex and concomitant cholecystectomy as independent risk factors for postoperative diarrhea. Prophylactic cholecystectomy during gastrectomy did not increase major complications, but it was associated with worse diarrhea-related symptoms and a lower QOL. Its indications should therefore be carefully considered, while balancing the potential benefits against the long-term functional outcomes.