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Effectiveness of Ursodeoxycholic Acid in the Prevention of Cholelithiasis After Sleeve Gastrectomy

  • Muriel CoupayeEmail author
  • Daniela Calabrese
  • Ouidad Sami
  • Nathalie Siauve
  • Séverine Ledoux
Original Contributions
  • 51 Downloads

Abstract

Purpose

The use of ursodeoxycholic acid (UDCA) to prevent gallstone formation after sleeve gastrectomy (SG) is still debated. Furthermore, no study has assessed the effectiveness of UDCA on gallstone formation after the first postoperative year. Our aim was to compare the incidence of cholelithiasis (CL) at 1 and 3 years after SG between patients treated or not treated with UDCA.

Materials and Methods

From January 2008, a postoperative ultrasound monitoring was scheduled for all patients who underwent SG in our institution. Patients with a preoperative intact gallbladder who performed at least one ultrasound at 1 year after SG were included. We compared the incidence of CL between patients operated before October 2013 who did not receive UDCA and those operated from October 2013 who received UDCA 500 mg once daily for 6 months postoperatively.

Results

The incidence of CL at 1 year after SG was 28% in the 46 non-treated and 3.5% in the 143 treated patients (p < 0.001). UDCA reduced the proportion of cholecystectomies from 11% to 1.4% (p = 0.012). Thus, the number of patients needed to treat to avoid a cholecystectomy was about 10. Only 2 patients (1.4%) stopped UDCA for adverse effects. No gallstone appeared at 3 postoperative years in the 61 patients who performed an ultrasound at this time.

Conclusion

UDCA 500 mg once daily for 6 months postoperatively is effective and well tolerated to prevent CL at midterm after SG. We recommend UDCA treatment in all patients after SG with an intact preoperative gallbladder. However, large randomized studies are needed to establish guidelines for prevention of gallstone formation after SG.

Keywords

Sleeve gastrectomy Gallstones Cholelithiasis Cholecystectomy Ursodeoxycholic acid 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Service des Explorations Fonctionnelles, Centre Intégré Nord Francilien de prise en charge de l’Obésité (CINFO), Hôpital Louis Mourier (AP-HP)Université Paris Diderot, Sorbonne Paris CitéColombes CedexFrance
  2. 2.Service de Chirurgie, Centre Intégré Nord Francilien de prise en charge de l’Obésité (CINFO), Hôpital Louis Mourier (AP-HP)Université Paris Diderot, Sorbonne Paris CitéColombesFrance
  3. 3.Service d’Imagerie Médicale, Hôpital Louis Mourier (AP-HP)Université Paris Diderot, Sorbonne Paris CitéColombesFrance

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