Prevention of gallstones by ursodeoxycholic acid after cardiac surgery

Abstract

The prophylactic administration of UDCA resulted in a significant decrease in the incidence of gallstones after open cardiac surgery.

Administration of ursodeoxycholate failed to prevent sludge and/or gallstone formation in cholecystokinin-1(A) receptor-deficient mice

“…Oral administration of UDCA could prevent gallstone formation after bariatric surgery, because rapid weight loss increases the risk for gallstone formation (24). Ai et al (1) reported that oral administration of UDCA (600 mg/day) prevented the development of gallstones after cardiac surgery and that the prophylactic administration of UDCA could result in a significant decrease in the incidence of gallstones after open cardiac surgery. Although administration of UDCA failed to prevent sludge and/ or gallstone formation in mice without surgical manipulation, administration of UDCA might be effective after surgery even in mice.…”

Prevention of black pigment gallstone formation after cardiac surgery by ursodeoxycholic acid

“…A protective effect of UDCA on hemolysis has been demonstrated in vitro. 12 However, Ai et al 1 did not find any significant difference in the indices of hemolysis during the early phase after surgery between patients with and without UDCA, a finding which does not support this possibility. Whether the deconjugation of bilirubin, or pH in bile is altered by UDCA was not examined.…”

“…Thus, the effect of UDCA on GB contractility is probably not the major factor contributing to its effect on black GS. Ai et al 1 raised another possibility-that bile flow increased by UDCA may have played some role. Unfortunately, they did not mention whether UDCA reduced the incidence of biliary sludge before the detection of GS on ultrasohography.…”

“…On the other hand, the reducing effects of UDCA on biliary mucin and nonmucin glycoproteins 13 probably played a significant role. With regard to GB contractility, Ai et al 1 examined preoperative GB contractility in 57 patients. In patients with good GB contractility, those who received UDCA showed a very low incidence of GS (4%) compared with those who did not receive UDCA (43%; P Ͻ 0.05).…”

“…Indeed, according to Ai et al, 1 the GS in 13 of 15 patients (87%) in the control group and in 4 of 4 patients (100%) in the UDCA group were considered to be black GS, judged from the ultrasonographic classification of GS proposed by Tsuchiya et al 2 The computer assisted tomography could be further enhanced by GB mucus glycoprotein hypersecretion and/or by GB hypomotility. 4,7 For the GS formed after open cardiac surgery, latent hemolysis is considered to be a major contributing factor.…”