Figure 1. The flowchart is describing the etiology and pathophysiology of CRC after CMY.

Following a CMY there is a change in the composition and secretion of bile acids, the metabolites of bile acids namely lithocholic acid and deoxycholic acid are secreted directly into the intestinal mucosa without a functional gall bladder, which in turn stimulate the intestinal mucosa leading to multiple cellular phenomena called apoptosis resistance, genomic instability, and bile acids hydrophobicity. These phenomena can cause colonic polyps over time, leading to cancer.

LCA: lithocholic acid, DCA: deoxycholic acid, CRC: colorectal cancer, CMY: cholecystectomy, BA: bile acids.