Ursodeoxycholic Acid in the Prevention of Gallstone Formation After Bariatric Surgery: an Updated Systematic Review and Meta-analysis

Abstract

We aim to review the available literature on obese patients treated with ursodeoxycholic acid (UDCA) in order to prevent gallstone formation after bariatric surgery. A systematic literature search was performed in PubMed, Cochrane library, and Scopus databases, in accordance with the PRISMA guidelines. Eight studies met the inclusion criteria incorporating 1355 patients. Random-effects meta-analysis showed a lower incidence of gallstone formation in patients taking UDCA. Subgroup analysis reported fewer cases of gallstone disease in the UDCA group in relation to different bariatric procedures, doses of administered UDCA, and time from bariatric surgery. Adverse events were similar in both groups. Fewer patients required cholecystectomy in UDCA group. No deaths were reported. The administration of UDCA after bariatric surgery seems to prevent gallstone formation.

Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

“…A meta-analysis of 6 RCTs and two observational studies found that ursodeoxycholic acid treatment versus no treatment was associated with lower odds of gallstone formation (OR 0.20, 95% CI 0.13 to 0.33) [129]. Due to mixed randomized and observational study design, substantial risk of bias and publication bias, certainty in the evidence was very low ( Supplementary Table S32).…”

Metabolism of Oxo-Bile Acids and Characterization of Recombinant 12α-Hydroxysteroid Dehydrogenases from Bile Acid 7α-Dehydroxylating Human Gut Bacteria

“…DCA and LCA are the main components of the bile acid profile of stool in healthy humans (6) and have been associated causally with diseases of the gastrointestinal (GI) tract, including cancers of the colon (7), liver (8), and esophagus (9), as well as cholesterol gallstone disease in a subset of patients (10). 7␤-Hydroxy bile acids, such as ursodeoxycholic acid (UDCA; 5␤-cholanic acid-3␣,7␤diol), are important in the therapy of the aforementioned GI diseases and function mainly to dilute and counteract the influence of microbe-derived DCA and LCA (11)(12)(13). UDCA synthesis from CA requires enzymatic oxidation of the 12␣-hydroxyl group, followed by Wolff-Kishner reduction to remove the C-12 carbonyl group (14).…”

Клиническая Эффективность Урсодезоксихолевой Кислоты В Комплексном Лечении Больных Ожирением И Гастроэзофагеальной Рефлюксной Болезнью

“…У фаховій науковій літературі активно обговорюються можливості використання УДХК при метаболічних розладах, а також у складі комплексної терапії, для нормалізації ваги тіла при ожирінні. Багато досліджень спрямовано на вивчення можливості використання УДХК для профілактики утворення каменів у жовчному міхурі на фоні зниження маси тіла [13,14], а також для профілактики ЖКХ та ураження печінки в баріатричній хірургії [15][16][17][18].…”