Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy.
BACKGROUND
Several studies have examined the role of ursodeoxycholic acid (UDCA) for the prevention of cholelithiasis (gallstones) following rapid weight loss from restrictive diets, vertical band gastroplasty, and Roux-en-Y gastric bypass. However, to date, there have been no prospective, controlled studies examining the role of UDCA for the prevention of gallstones following sleeve gastrectomy (SG). This study was conducted to identify the effectiveness of UDCA for prevention of gallstones after SG.


METHODS
Following SG, eligible patients were randomized to a control group who did not receive UDCA treatment or to a group who were prescribed 300 mg UDCA twice daily for 6 months. Gallbladder ultrasounds were performed preoperatively and at 6 and 12 months postoperatively. Patients with positive findings preoperatively were excluded from the study. Compliance with UDCA was assessed.


RESULTS
Between December 2011 and April 2013, 37 patients were randomized to the UDCA treatment arm and 38 patients were randomized to no treatment. At baseline, the two groups were similar. At 6 months, the UDCA group had a statistically significant lower incidence of gallstones (p = 0.032). Analysis revealed no significant difference in gallstones between the two groups at 1 year (p = 0.553 and p = 0.962, respectively). The overall gallstone formation rate was 29.8%.


CONCLUSIONS
The incidence of gallstones is higher than previously estimated in SG patients. UDCA significantly lowers the gallstone formation rate at 6 months postoperatively.
College of Applied and Natural Sciences, Louisiana Tech University, Ruston, LA, 71272, USA.
Lindsay B
LB
Adams
, 6502 Nursery Drive Suite 300, Victoria, TX, 77901, USA. craiggchangmd@gmail.com.
Craig
C
Chang
College of Applied and Natural Sciences, Louisiana Tech University, Ruston, LA, 71272, USA.
Janet
J
Pope
College of Applied and Natural Sciences, Louisiana Tech University, Ruston, LA, 71272, USA.
Yeonsoo
Y
Kim
College of Applied and Natural Sciences, Louisiana Tech University, Ruston, LA, 71272, USA.
Pei
P
Liu
College of Applied and Natural Sciences, Louisiana Tech University, Ruston, LA, 71272, USA.
Amy
A
Yates
D000328:Adult; D005260:Female; D042882:Gallstones / Q000209:etiology / Q000517:prevention & control*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010349:Patient Compliance; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D014580:Ursodeoxycholic Acid
Cholelithiasis; Gallstones; Sleeve gastrectomy; Ursodeoxycholic acid; Ursodiol