Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial

Talha, Ahmed; Abdelbaki, Tamer N.; Farouk, Ayman; Hasouna, Ehab; Azzam, Eman Zaki; Shehata, Gihan M.

doi:10.1007/s00464-019-07323-7

Cited by 52 publications

(43 citation statements)

References 30 publications

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“…Finally, we included 11 RCTs and 10 non‐RCTs, for a total of 5365 patients, in this meta‐analysis. Table 1 summarizes the detailed information of each included study 3,17‐20,29‐44 …”

Section: Resultsmentioning

confidence: 99%

Ursodeoxycholic acid for the prevention of gallstone and subsequent cholecystectomy following gastric surgery: A systematic review and meta‐analysis

Choi

Lee

Cho

et al. 2021

J Hepato Biliary Pancreat

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Background/Purpose: Patients who undergo gastric surgery are prone to form postsurgical gallstones. Debates still exist about the need for prevention and the selection of preventive methods. No studies had been reported comparing the efficacy of prophylactic ursodeoxycholic acid (UDCA) and prophylactic cholecystectomy (PC) for lowering postsurgical gallstone formation and subsequent cholecystectomy (SC) in patients who have undergone gastric surgery. Methods: We did a systematic review to identify studies from PUBMED, EMBASE, and the Cochrane database through 30 June 2020. We conducted direct and indirect comparisons of each prophylaxis using conventional and network meta-analysis.Studies with patients who have no history of cholecystectomy and who have not had preoperative gallstone were included. Results: The excellent preventive effects of PC and UDCA were demonstrated for gallstone formation (odds ratio [OR] 0.05, [95% CI 0.01, 0.22] and 0.20, [95% CI 0.16, 0.24], respectively) and the need for SC (OR 0.10, [95% CI 0.02, 0.57] and OR 0.22, [95% CI 0.14, 0.35], respectively) than control group. The UDCA group showed a tendency to generate more gallstones (OR 3.74, [95% CI 0.88, 15.82]) and a greater need for SC (OR 2.19,) than did the PC group without statistical significance. Conclusions: Prophylaxis for gallstone formation may be needed for patients who undergo gastric surgery to reduce troublesome morbidities. Prophylactic UDCA seems to be a reasonable preventive method for postsurgical gallstone formation to ensure clinical benefit while reducing the burden of subsequent cholecystectomy for the patient as compared to a PC.

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Section: Resultsmentioning

confidence: 99%

Ursodeoxycholic acid for the prevention of gallstone and subsequent cholecystectomy following gastric surgery: A systematic review and meta‐analysis

Choi

Lee

Cho

et al. 2021

J Hepato Biliary Pancreat

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“…surgery for obesity is estimated to be around 10% within 10 years after surgery. 22 One theory behind this association included decreased postoperative fat-soluble vitamin absorption resulting in reductions in active vitamin D and increased oxalate levels. This resulted in low calcium reabsorption in the intestines allowing for oxalate precipitation and stone formation.…”

Section: Discussionmentioning

confidence: 99%

Bariatric Metabolic Surgery Reduced Liver Enzyme Levels in Patients with Non-Alcohol Fatty Liver Disease

Kirkpatrick

Paull-Forney

Okut

et al. 2021

kjm

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Introduction. Approximately 93.3 million Americans are obese (BMI>30) and 51% have non-alcoholic fatty liver disease (NAFLD). Progression of NAFLD can lead to Non-Alcoholic Steatohepatitis (NASH), the leading cause of liver transplant in the United States. This study analyzed liver enzymes following bariatric surgery in NAFLD patients up to one-year post-surgical intervention. Methods. A retrospective analysis of adults with NAFLD who underwent bariatric surgery from 2009 to 2016 was conducted. The primary outcome were transaminase levels following weight loss. Secondary outcomes included effects on blood glucose, lipids, and blood pressure. Results. A total of 130 participants consisting of 80% Caucasian females with an average BMI of 47.5 participated in the study. Reductions were noted in ALT (66.2 to 28.6 units/L) and AST (46.3 to 24.2 units/L) at 1 year post-surgical intervention. Significant reductions were also noted in blood glucose (22.34%; p < .0001), HbA1c (17.11% p < .0001), LDL (19.75% p = .0046), total cholesterol (10.12% p = .0153), and triglycerides (37.21% p < .0001) with an increase in HDL (17.22% p = .0007). Significant correlations between alkaline phosphatase and ALT were noted at six months (p=.0101) and one year (p= .0547) and AST at six months (p=.0009). When separated by obesity class, participants with class II obesity experienced improved outcomes. Conclusions. Data obtained from this study indicated that bariatric surgery reduces liver enzyme levels in NAFLD. These findings suggest that bariatric surgery is a viable treatment option for participants with NAFLD.

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“…Нами проведен литературный поиск в сети MEDLINE: поисковый запросbariatric surgery AND ursodeoxycholic acid. Найдено 12 исследований применения урсодезоксихолевой кислоты после бариатрических операций [6][7][8][9][10][11][12][13][14][15][16][17][18]. Во всех работах было показано снижение частоты возникновения конкрементов в желчном пузыре при использовании профилактических дозировок препарата (табл.…”

Section: Discussionunclassified

Ursodeoxycholic acid for the prevention of gallstone disease after bariatric surgery

Смирнов

Вячеславович²,

Ivanov

et al. 2021

Journal of Clinical Practice

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Background: The development of gallstone disease (GSD) after bariatric surgery is a significant problem. The prophylactic effect of ursodeoxycholic acid (UDCA) preparations on the occurrence of cholelithiasis after gastric bypass and longitudinal gastrectomy has been studied. Aims: The aim of the study was to evaluate the effectiveness of ursodeoxycholic acid preparations in the prevention of cholelithiasis in patients after bariatric surgery. Methods: The results of a year-long follow-up for 128 patients after bariatric surgery were analyzed. In 68 patients, the prophylaxis of the gallstone disease development was not performed. 60 patients took a daily 500 mg dose of UDCA orally. Results: Cholelithiasis had developed in 17 (25%) patients who did not undergo the prophylaxis of cholelithiasis. Of these, 10 (14.7%) underwent cholecystectomy. Among those patients who took UDCA drugs, stones in the gallbladder were found in 7 (11.6%), and only one patient (1.7%) required a surgical treatment. Conclusion: UDCA administration during the first year after bariatric surgery in the amount of 500 mg per day significantly reduces the likelihood of the de novo cholelithiasis development. The medical prophylaxis of gallstone disease should be included in the standards of bariatric patients' management.

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Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial

Cited by 52 publications

References 30 publications

Ursodeoxycholic acid for the prevention of gallstone and subsequent cholecystectomy following gastric surgery: A systematic review and meta‐analysis

Ursodeoxycholic acid for the prevention of gallstone and subsequent cholecystectomy following gastric surgery: A systematic review and meta‐analysis

Bariatric Metabolic Surgery Reduced Liver Enzyme Levels in Patients with Non-Alcohol Fatty Liver Disease

Ursodeoxycholic acid for the prevention of gallstone disease after bariatric surgery

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