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Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy
Abstract
Background Several studies have examined the role of ursodeoxycholic acid (UDCA) for the prevention of cholelithiasis (gallstones) following rapid weight loss from restrictive diets, vertical band gastroplasty, and Roux-en-Y gastric bypass. However, to date, there have been no prospective, controlled studies examining the role of UDCA for the prevention of gallstones following sleeve gastrectomy (SG). This study was conducted to identify the effectiveness of UDCA for prevention of gallstones after SG. Methods Following SG, eligible patients were randomized to a control group who did not receive UDCA treatment or to a group who were prescribed 300 mg UDCA twice daily for 6 months. Gallbladder ultrasounds were performed preoperatively and at 6 and 12 months postoperatively. Patients with positive findings preoperatively were excluded from the study. Compliance with UDCA was assessed. Results Between December 2011 and April 2013, 37 patients were randomized to the UDCA treatment arm and 38 patients were randomized to no treatment. At baseline, the two groups were similar. At 6 months, the UDCA group had a statistically significant lower incidence of gallstones (p = 0.032). Analysis revealed no significant difference in gallstones between the two groups at 1 year (p = 0.553 and p = 0.962, respectively). The overall gallstone formation rate was 29.8%. Conclusions The incidence of gallstones is higher than previously estimated in SG patients. UDCA significantly lowers the gallstone…
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In extremely rapid weight loss and excessive weight reduction, the risk of gallstones occurring increases.
“In both of these cases, the risk of gallstones occurring increases [28,29].”
From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [29]
Ursodeoxycholic acid reduces the formation of cholesterol gallstones during rapid weight loss induced by very low-calorie diets or bariatric surgery.
“There is robust evidence that ursodeoxycholic acid reduces the formation of cholesterol gallstones during rapid weight loss induced by very low-calorie diets or bariatric surgery.6,14,15”
The moderate overall compliance of 63% in our trial is consistent with compliance rates reported in other trials.
“The moderate overall compliance of 63% in our trial is consistent with compliance rates reported in other trials, 6,8,35,36 although higher rates have been reported as well.7,25,37,38”
The type of bariatric procedure is associated with the incidence and timing of gallstone formation.
“Several studies have implied that the type of bariatric procedure is associated with the incidence and timing of gallstone formation.”
From Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures (2022) · cites this paper as [26]
The time of gallstone formation differs according to the type of procedure; approximately 30% of gallstones occur within 6 months after RYGB or biliopancreatic diversion, whereas a comparable incidence occurs at 6-12 months after SG.
“previous studies have demonstrated that the time of gallstone formation differs according to the type of procedure; approximately 30% of gallstones were reported within 6 months after Roux-en-Y gastric bypass (RYGB) or biliopancreatic diversion, whereas a comparable incidence was reported at 6–12 months after sleeve gastrectomy (SG) [242526].”
From Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures (2022) · cites this paper as [26]
Only 11 randomized controlled trials have reported the effect of UDCA on gallstone formation after bariatric surgery.
“However, only 11 randomized controlled trials have reported the effect of UDCA on gallstone formation after bariatric surgery (Table 3) [1225264849505152535455].”
From Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures (2022) · cites this paper as [26]
Citations
Cites
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Cited by
Sorted by citations
Magouliotis, D. E., Tasiopoulou, V. S., Svokos, A. A., Svokos, K. A., Chatedaki, C., Sioka, E., & Zacharoulis, D. (2017) · Obesity Surgery · doi:10.1007/s11695-017-2924-y · Cited by 108
Haal, S., Guman, M. S. S., Boerlage, T. C. C., Acherman, Y. I. Z., de Brauw, L. M., Bruin, S., de Castro, S. M. M., van Hooft, J. E., van de Laar, A. W. J. M., Moes, D. E., et al. (2021) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(21)00301-0 · Cited by 82
Excess Body Weight and Gallstone Disease
Stokes, C. S., & Lammert, F. (2021) · Visceral Medicine · doi:10.1159/000516418 · Cited by 58
Son, S.-Y., Song, J. H., Shin, H.-J., Hur, H., & Han, S.-U. (2022) · Journal of Metabolic and Bariatric Surgery · doi:10.17476/jmbs.2022.11.2.30 · Cited by 23
Metadata
- Authors
- Adams, L. B., Chang, C., Pope, J., Kim, Y., Liu, P., & Yates, A.
- Venue
- Obesity Surgery
- Published
- 2015-09-05
- Volume
- 26
- Issue
- 5
- Pages
- 990-994
- ISSN
- 0960-8923
- 1708-0428
- Cited by
- 71
- References
- 1
- Language
- en
- Licence
- www.springer.com/tdm (tdm)
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