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

Abstract

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.

Ursodeoxycholic Acid Prophylaxis and the Reduction of Gallstone Formation After Bariatric Surgery: An Updated Meta-Analysis of Randomized Controlled Trials

“…This difference was sustained up to six months and one year after surgery. These findings are similar to findings of previous meta-analysis conducted by Ying et al [ 20 ], Fearon et al [ 19 ], and Magouliotis et al [ 21 ].…”

“…While some RCTs found that prophylactic administration of UDCA is associated with reduced gall stones [28,29], the RCT conducted by Wudel et al revealed UDCA has no preventive role [22]. There are some meta-analyses performed to identify the role of UDCA in preventing gallstones after bariatric surgery, but these meta-analyses included retrospective studies, prospective studies, and RCTs [19][20][21].…”

“…Such efforts include prophylactic cholecystectomy during bariatric surgery [14,17,18]. Others include the administration of ursodeoxycholic acid (UDCA) after the surgery to reduce the risk of gallstone formation and cholecystectomy with its attending complications [19][20][21]. There have been studies assessing the role of UDCA prophylaxis in preventing gallstone formation with conflicting results.…”