Ursodeoxycholic acid in the prevention of gallstones in patients subjected to Roux-en-Y gastric bypass

Abstract

Purpose To evaluate the contribution of ursodeoxycholic acid (UDCA) in the first 12 months after Roux-en-Y gastric bypass in the prevention of gallstone formation. Methods A community-based clinical trial was conducted. A total of 137 patients were included in the study; 69 were treated with UDCA, starting 30 days after the surgery, at a dose of 150 mg twice daily (300 mg/day) over a period of 5 consecutive months (GROUP A), and 68 were control patients (GROUP B). The patients were followed-up, and ultrasonography was performed to determine the presence of gallstones at various times during follow-up. Demographic, anthropometric and comorbid indicators were obtained. The data were subjected to normality tests and evaluated using appropriate tests. Results Patients did not differ in their baseline characteristics. Of the 69 patients who used UDCA, only one patient developed cholelithiasis (1%), whereas 18 controls (26%) formed gallstones (OR = 24.4, p <0.001). Also, other factors were found not to influence the formation of calculi, such as pre-operative or postoperative hepatic steatosis or diabetes (p = 0.759, 0.468, 0.956). Conclusion The results demonstrated that patients who did not use UDCA showed a 24.4-fold greater probability of developing cholelithiasis.

Risk Factors for Symptomatic Gallstone Disease and Gallstone Formation After Bariatric Surgery

“…Despite extensive research, it is currently not possible to predict the risk for gallstones in the individual bariatric patient. Most previous studies did not identify any preoperative risk factors [2,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], whereas others found inconsistent associations between gender, age, ethnicity, the presence of comorbidities (such as pain syndrome, hypertension, type 2 diabetes, dyslipidemia, fatty liver disease and insulin resistance), the use of statins, or type of surgery on the one hand, and symptomatic gallstone disease or gallstone formation after bariatric surgery on the other hand [4,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Although the postoperative weight loss predisposes bariatric patients to develop gallstones, it cannot be predicted beforehand.…”

Ursodeoxycholic acid for the prevention of gallstone disease after bariatric surgery

“…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.…”

The use of Ursodesoxicolic Acid in Prevention of Collelitiase After Bariatric Surgery: A Systematic Review of Literature

“…O UDCA apresenta como benefícios proporcionar o bloqueio da evolução do quadro da doença hepática gordurosa não hepática para esteato-hepatite não alcoólica, decorrente da proteção gerada aos hepatócitos durante o manuseio de sais biliares em trauma mitocondrial. Além disso, é considerado como via de sinalização anti-apoptótica, função anti-inflamatória, antioxidante, imunomodulatória, propriedades anti-fibrótica (Machado et al, 2019).…”

“…Diante desse cenário, a necessidade da realização de procedimentos cirúrgicos tornou-se ainda mais frequente, apresentando dados anuais nos Estados Unidos de 140.000. Quando se avalia o Brasil, foi detectado que 38,8 milhões de brasileiros com idade superior a 20 anos apresentavam sobrepeso e 11% eram considerados obesos (Machado et al, 2019). O excesso de peso promove um aumento de diversos problemas de saúde, destacando disfunções cardíacas, hipertensão arterial, diabetes tipo II, osteoartrite como…”