Gut-brain axis disruption, intestinal barrier damage, and systemic inflammation as predictors of POCD after cholecystectomy: a nested case-control study

The study examined postoperative cognitive dysfunction (POCD) in patients after gallbladder removal. Among 361 patients, POCD developed in 24 patients (6.7%), who were compared with 48 control patients without POCD. The research found that POCD patients had elevated levels of intestinal permeability markers and inflammatory substances. Increased postoperative levels of lipopolysaccharide-binding protein (LBP) and interleukin-6 (IL-6) were identified as independent risk factors, while higher preoperative cognitive function was a protective factor. The results confirm that gut-brain axis disruption and systemic inflammation play a key role in POCD development. LBP and IL-6 are major biomarkers with high predictive value for POCD risk.