Comparison of Preoperative and Postoperative Serum 25-Hydroxyvitamin D Levels and Vitamin K-Dependent Blood Coagulation Factor Profiles in Patients Undergoing Cholecystectomy.

BACKGROUND Cholecystectomy alters enterohepatic bile circulation, impairing fat-soluble vitamin absorption and reducing bioavailability of vitamin D and vitamin K, required for hepatic synthesis of coagulation factors II, VII, IX, and X. Despite the high global frequency of this procedure, evidence regarding clinically significant postoperative changes in fat-soluble vitamin status remains inconsistent. This retrospective single-center study compared preoperative and postoperative serum 25-hydroxyvitamin D (25[OH]D) levels and vitamin K-dependent coagulation profiles in patients undergoing cholecystectomy. MATERIAL AND METHODS All data were retrieved from electronic medical records of patients who underwent cholecystectomy between January 2020 and January 2025. Two distinct cohorts were formed: the vitamin K cohort (n=101), in which prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR) were evaluated at ≥7 days postoperatively; and the 25(OH)D cohort (n=78), in which serum 25(OH)D levels were evaluated at ≥3 months postoperatively. Patients with comorbidities or medications affecting these parameters were excluded. RESULTS In the 25(OH)D cohort, no significant difference was found between preoperative and postoperative median levels (19.76 vs 19.13 µg/L, P=0.248). In the vitamin K cohort, no significant changes were detected in PT (11.80 vs 11.67 s, P=0.301), aPTT (29.83 vs 30.40 s, P=0.131), or INR (1.03 vs 1.03, P=0.859). Sex-stratified analyses revealed no significant differences. CONCLUSIONS Cholecystectomy was not associated with a clinically significant decline in serum 25(OH)D or alterations in vitamin K-dependent coagulation profiles. Postoperative insufficiencies appear driven by pre-existing metabolic risk profiles. Clinical management should prioritize preoperative metabolic optimization over routine post-surgical supplementation.