Ursodeoxycholic Acid for 6 Months After Bariatric Surgery Is Impacting Gallstone Associated Morbidity in Patients with Preoperative Asymptomatic Gallstones

Penna, Andrea Della; Lange, Jessica; Hilbert, Julia; Archid, Rami; Königsrainer, Alfred; Quante, Markus

doi:10.1007/s11695-018-03651-0

Cited by 26 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A large RCT revealed that UDCA does not prevent the development of postoperative symptoms in patients with preoperative asymptomatic gallstones (28). Conversely, the results of Della Penna et al showed that UDCA could prevent asymptomatic gallstones from developing symptoms (48). However, their trial lacked a control group, and the authors reached their conclusions by comparing the incidence to previous studies, which undoubtedly introduced bias.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta‐analysis

Ying

Dai

et al. 2022

Obesity

View full text Add to dashboard Cite

Objective Bariatric surgery increases the risk of postoperative gallstone formation. Many studies have proposed ursodeoxycholic acid (UDCA) as a preventive agent for postoperative gallstone formation. This study aimed to investigate the effect of UDCA on gallstone formation after bariatric surgery in patients without preoperative gallstones. Methods PubMed, the Web of Science, the Cochrane Library, and EBSCO were searched for articles assessing the effect of UDCA on gallstone formation after bariatric surgery. The outcome was the incidence of postoperative gallstones. Odds ratios were used to assess dichotomous variables, and random‐effects models were used for statistical analyses. Results A total of 18 studies including 4,827 participants met the inclusion criteria. The statistical results showed that the incidence of gallstones in the UDCA group was significantly lower than in the control group. Furthermore, the occurrence of symptomatic gallstones and cholecystectomy was significantly reduced. Conclusions In patients without preoperative gallstones, UDCA can effectively prevent the formation of gallstones after bariatric surgery. In addition, UDCA can significantly reduce the occurrence of symptomatic gallstones and the risk of postoperative cholecystectomy. Doses of 500 to 600 mg/d can be used as a measure to prevent postoperative gallstone formation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…According to certain studies, the rapid weight loss caused by bariatric surgery, which is a risk factor for gallstones, occurs primarily in the first 6 months (25,31,45,48,50). Therefore, a large number of clinical trials have been designed to administer UDCA as a prophylactic measure for 6 months.…”

Section: Discussionmentioning

confidence: 99%

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta‐analysis

Ying

Dai

et al. 2022

Obesity

View full text Add to dashboard Cite

show abstract

“…These risks do, however, differ depending on the type of bariatric surgery, with the laparoscopic Roux-en-Y surgery displaying a higher risk than either gastric banding or sleeve resection [48]. Two recent studies corroborated the guideline recommendations; Della Penna et al [49] followed up 61 patients with asymptomatic gallstones treated with ursodeoxycholic acid (UDCA) for 6 months after bariatric surgery (either laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy). Cholecystectomy was required in 1 patient only who had undergone sleeve gastrectomy.…”

Section: Prevention and Treatment Of Gallstones In Obesitymentioning

confidence: 99%

Excess Body Weight and Gallstone Disease

Stokes

Lammert

2021

Visc Med

View full text Add to dashboard Cite

Background: Approximately one fifth of adults are diagnosed with gallstones worldwide. Of these, around 25% develop gallstone disease (indicated by the presence of symptoms) and undergo cholecystectomy. Summary: The risk of gallstones is influenced by a combination of genetic and lifestyle factors, such as excess body weight. In fact, body mass has been demonstrated to be a major risk factor for symptomatic gallstones. Rapid weight loss can also initiate a prolithogenic state and further increase the likelihood of either gallstone formation or existing gallstones becoming symptomatic; however, sensible weight loss strategies can mitigate this risk. This review discusses the role of excess body weight and the risk of gallstone disease, as well as the options available for the prevention of symptomatic gallstones. Key Messages: Healthy weight loss diets combined with regular physical activity can promote successful weight loss and weight maintenance and reduce the risk of gallstones. Should rapid weight loss be required for health reasons or be expected, e.g., after bariatric surgery, prophylactic ursodeoxycholic acid during the period of weight reduction has been demonstrated to reduce the incidence of gallstones formation or symptomatic gallstone occurrence. The recent German guidelines on gallstones recommend simultaneous cholecystectomy during bariatric surgery but only for those with preexisting symptomatic stones.

show abstract

“…The reason why the rate of postoperative symptomatic cholelithiasis was low in our study may be due to postoperative patients using 500 mg UDCA daily for 6 months. In a similar study conducted by Della Penna et al 14 in patients with gastric bypass and LSG (n = 61), the rate of postoperative symptomatic cholelithiasis was 3.3%.…”

Section: Discussionmentioning

confidence: 62%

Risk of Asymptomatic Gallstones Becoming Symptomatic After Laparoscopic Sleeve Gastrectomy

Şen

Türkçapar²

2021

The American Surgeon

View full text Add to dashboard Cite

Background Whether concomitant cholecystectomy is needed during laparoscopic sleeve gastrectomy (LSG) in patients with asymptomatic cholelithiasis is controversial. In this study, our aim is to show the follow-up results in patients with asymptomatic cholelithiasis who underwent LSG alone. Methods Patients undergoing primary LSG between March 2018 and September 2020 with asymptomatic gallbladder stones were included in this retrospective study. All patients underwent abdominal ultrasound (US) before surgery. Patients’ demographics and postoperative outcomes were recorded. Results A total of 180 patients underwent primary LSG and completed the 1-year follow-up. The study population consisted of 42 patients (23%) with asymptomatic cholelithiasis. The mean age was 41.1±7.1 years (31-56, 63% female), and mean body mass index (BMI) was 44 ± 6.7 kg/m2. Average BMI decreased to 31.1 ± 4.7 kg/m2 at 6 months and to 27.3 ± 3.6 kg/m2 at 1 year. The average follow-up period was 17 ± 5.7 months (range, 12-28 months). Of the 42 patients, only 1 patient (2.4%) became symptomatic during the follow-up period. Discussion We do not recommend cholecystectomy in patients with asymptomatic gallstones during the same session with LSG. An observational approach should be adopted for these patients.

show abstract

Ursodeoxycholic Acid for 6 Months After Bariatric Surgery Is Impacting Gallstone Associated Morbidity in Patients with Preoperative Asymptomatic Gallstones

Cited by 26 publications

References 23 publications

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta‐analysis

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta‐analysis

Excess Body Weight and Gallstone Disease

Risk of Asymptomatic Gallstones Becoming Symptomatic After Laparoscopic Sleeve Gastrectomy

Contact Info

Product

Resources

About