Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures

Son, Sang‐Yong; Song, Jeong Ho; Shin, Ho-Jun; Hur, Hoon; Han, Sang‐Uk

doi:10.17476/jmbs.2022.11.2.30

Cited by 3 publications

(10 citation statements)

References 55 publications

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“…While rates vary, most studies report an incidence rate of cholelithiasis around 20%-30% after bariatric surgery [18][19][20] . Bariatric surgery patients with preoperative asymptomatic gallstones had a 15% chance of developing postoperative symptomatic gallstone disease, revealing a statistically significant increase compared to patients with no prior history [21] . Symptomatic cholelithiasis can lead to abdominal pain, jaundice, acute cholecystitis, biliary colic, and pancreatitis [22,23] .…”

Section: Gallstonesmentioning

confidence: 92%

“…Other studies [16] have also revealed a decrease in symptomatic gallstones with prophylactic UDCA, decreasing the need for postoperative cholecystectomy. In a study by Haal et al, the effect of UDCA prophylaxis in patients with preoperative gallstones was negligible [21] . While prophylactic cholecystectomy was previously recommended, the increased rate of complications, hospital stays, and mortality have led to a decline in this practice [22] .…”

Section: Gallstonesmentioning

confidence: 96%

“…Treatment for gallstone formation after bariatric surgery has been controversial, as multiple factors influence the incidence of development, including the patient's history of gallstones [21] . Prophylactic ursodeoxycholic acid (UDCA) in the first 6 postoperative months resulted in a significant decrease in post-bariatric gallstone formation from 22% in the placebo group to 6.5% in the treated group [5] .…”

Section: Gallstonesmentioning

confidence: 99%

“…In the future, patients should be educated about their risk and consider suggested treatment options such as prophylactic UDCA and monitoring with ultrasound [17] . Given recent evidence, further studies should be conducted to determine the influence of statins on reducing risk [21] . Data should continue to be collected to guide physicians and patients on surgical and pharmaceutical prevention and treatment.…”

Section: Gallstonesmentioning

confidence: 99%

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Long-term complications of significant weight loss: lessons learned from bariatric surgery

Harrington,

Kang,

Telesca

et al. 2023

Metab Target Organ Damage

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The increasing prevalence of worldwide obesity calls for a comprehensive understanding of available treatment options. Bariatric surgery remains a very effective obesity treatment, showing substantial effects on obesity-related complications, including type 2 diabetes mellitus and cardiovascular disease, mainly related to significant long-term weight loss. Besides the benefits, weight loss can lead to some deleterious consequences, such as gallstones, constipation, muscle mass loss, bone fractures, vitamin deficiencies, peripheral neural palsy, suicide, eating disorders, alcohol dependency syndrome, and increased divorce. Those consequences may also be seen after long-term effective pharmacotherapy for obesity. Understanding these risks will lead to improved awareness and successful treatment with both surgical and nonsurgical treatments.

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Section: Gallstonesmentioning

confidence: 92%

Section: Gallstonesmentioning

confidence: 96%

Section: Gallstonesmentioning

confidence: 99%

Section: Gallstonesmentioning

confidence: 99%

See 2 more Smart Citations

Long-term complications of significant weight loss: lessons learned from bariatric surgery

Harrington,

Kang,

Telesca

et al. 2023

Metab Target Organ Damage

View full text Add to dashboard Cite

show abstract

“…The recognized risk factors associated with cholelithiasis include age over 40, female gender, adiposity, fair complexion, and fertility (collectively referred to as the "5 Fs"). Additionally, dyslipidemia, prior upper gastrointestinal surgeries, and dietary patterns are acknowledged to elevate the risk of gallstone formation[ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis

Ribeiro Jr,

Tebar,

Niero

et al. 2024

World J Gastrointest Pharmacol Ther

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Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss. Patients with a body mass index > 40 face an eightfold risk of developing cholelithiasis. Post-bariatric surgery, especially after laparoscopic Roux-en-Y gastric bypass (LRYGB), 30% of patients develop biliary disease due to rapid weight loss. The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management. A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO, PubMed, and MEDLINE. Patients undergoing LRYGB have a higher incidence (14.5%) of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%. Key biliary complications within 6 to 12 months post-surgery include: Cholelithiasis: 36%; Biliary colic/dyskinesia: 3.86%; Acute cholecystitis: 0.98%-18.1%; Chronic cholecystitis: 70.2%; Choledocholithiasis: 0.2%-5.7% and Pancreatitis: 0.46%-9.4%. Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.

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The ABCG8 polymorphism increases the risk of gallbladder cancer in the general population and gallstones in obese patients from Poland

Krupa,

Kalinowski,

Ligocka

et al. 2024

Eur J Clin Investigation

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BackgroundGallstone disease (GD) is common but remains asymptomatic in most cases. However, gallstones can lead to complications like choledocholithiasis or gallbladder cancer. In this study, we analyse the common genetic risk factor for GD, the p.D19H variant in the sterol transporter ABCG8, in Polish patients with gallstones and gallbladder cancer.MethodsThree adult cohorts were prospectively recruited: 65 patients with gallbladder cancer, 170 obese individuals scheduled for bariatric surgery and 72 patients who underwent endoscopic retrograde cholangiopancreatography due to recurrent choledocholithiasis. The control cohort consisted of 172 gallstone‐free adults. The ABCG8 p.D19H (rs11887534) polymorphism was genotyped using TaqMan assays.ResultsThe minor allele frequency (MAF) of the ABCG8 p.D19H polymorphism was significantly (p = .02) higher among cases with either gallstones or gallbladder cancer (MAF = 8.4%) as compared to controls (MAF = 4.0%). The highest frequency of the risk allele was detected in patients with gallbladder cancer (18.5%) and obese patients with GD (17.5%), followed by individuals with choledocholithiasis (13.9%). Notably, the p.19H variant was associated with an increased risk of developing gallbladder cancer (OR 2.76, 95% CI 1.16–6.54, p = .01) and an increased risk of GD in obese individuals scheduled for bariatric surgery (OR = 2.70, 95% CI 1.05–6.49, p = .03), but did not significantly affect the risk of choledocholithiasis.ConclusionsThe ABCG8 p.D19H common risk variant increases the risk of developing gallbladder cancer in Central Europeans and enhances the risk of gallstones in the obese. Carriers of the p.D19H variant might benefit from personalized preventive strategies, particularly regarding gallbladder cancer.

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Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures

Cited by 3 publications

References 55 publications

Long-term complications of significant weight loss: lessons learned from bariatric surgery

Long-term complications of significant weight loss: lessons learned from bariatric surgery

Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis

The ABCG8 polymorphism increases the risk of gallbladder cancer in the general population and gallstones in obese patients from Poland

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