Post-Cholecystectomy nutritional management: a comprehensive review of evidence-based guidelines and clinical practice

Vollständiger Abstract

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Background Cholecystectomy is one of the most common abdominal surgeries worldwide, yet postoperative nutritional management remains variable. This review synthesizes current evidence on nutritional care after cholecystectomy, with a focus on actionable insights for clinicians. Methods We conducted a non-systematic narrative review of English-language literature published from January 2010 through June 2026, supplemented by manual searches of guidelines. Due to the narrative design, we did not perform a formal risk-of-bias assessment or meta-analysis. Findings Postoperative gastrointestinal symptoms (e.g., bloating, diarrhea, dyspepsia) are common, but their incidence and etiology vary widely. Early oral feeding within 24 h may reduce hospital stay. High-risk patients (diabetes, obesity, elderly) may benefit from protein supplementation (1.2–1.5 g/kg/day) and selective fat-soluble vitamin monitoring when clinically indicated. We provide a risk-stratified algorithm, critically appraise conflicting evidence, and identify knowledge gaps. While standardized ERAS protocols exist for elective cases, complicated scenarios (acute cholecystitis, post-pancreatitis) require special consideration. Conclusion This review provides an evidence-informed, cautious framework for individualized postoperative nutritional support, emphasizing that most recommendations are extrapolated from other surgical populations and require validation in cholecystectomy-specific trials.