The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial
Introduction Bariatric surgery leads to rapid weight loss, a well-known risk factor for gallstone formation. Postoperative biliary complication rate requiring cholecystectomy is between 0.9 and 7.5% after laparoscopic sleeve gastrectomy and between 6 and 50% after laparoscopic gastric bypass. Severa...
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| Veröffentlicht in: | Obesity surgery 2020-11, Vol.30 (11), p.4315-4324 |
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| description | Introduction
Bariatric surgery leads to rapid weight loss, a well-known risk factor for gallstone formation. Postoperative biliary complication rate requiring cholecystectomy is between 0.9 and 7.5% after laparoscopic sleeve gastrectomy and between 6 and 50% after laparoscopic gastric bypass. Several authors recommended ursodeoxycholic acid (UDCA) administration to reduce gallstone formation after diet-induced weight reduction. The aim of this randomized monocentric study is to evaluate gallstone incidence after prophylactic administration of UDCA in patients undergoing one anastomosis gastric bypass (OAGB).
Methods
Patients undergoing OAGB were prospectively randomized into 2 groups: the UDCA group receiving oral UDCA 600 mg/days for 6 months in the immediate postoperative days, and the control group not administered with UDCA. Each group included 95 patients. Abdominal ultrasound, clinical evaluation, and quality of life scoring with Gastrointestinal Quality of Life Index (GIQLI) were performed postoperatively in all patients at 3, 6, and 12 months.
Results
At 12 months of postoperative follow-up, 4 (4.2%) and 24 patients (25.2%) showed gallstones in the UDCA group and control group, respectively (
p
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| doi_str_mv | 10.1007/s11695-020-04801-z |
| format | Article |
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Bariatric surgery leads to rapid weight loss, a well-known risk factor for gallstone formation. Postoperative biliary complication rate requiring cholecystectomy is between 0.9 and 7.5% after laparoscopic sleeve gastrectomy and between 6 and 50% after laparoscopic gastric bypass. Several authors recommended ursodeoxycholic acid (UDCA) administration to reduce gallstone formation after diet-induced weight reduction. The aim of this randomized monocentric study is to evaluate gallstone incidence after prophylactic administration of UDCA in patients undergoing one anastomosis gastric bypass (OAGB).
Methods
Patients undergoing OAGB were prospectively randomized into 2 groups: the UDCA group receiving oral UDCA 600 mg/days for 6 months in the immediate postoperative days, and the control group not administered with UDCA. Each group included 95 patients. Abdominal ultrasound, clinical evaluation, and quality of life scoring with Gastrointestinal Quality of Life Index (GIQLI) were performed postoperatively in all patients at 3, 6, and 12 months.
Results
At 12 months of postoperative follow-up, 4 (4.2%) and 24 patients (25.2%) showed gallstones in the UDCA group and control group, respectively (
p
< 0.05). Among those who developed gallstones, 8 (28.6%) cases were symptomatic whereas 20 (71.4%) did not show any symptom. No statistically significant difference in GIQLI score between the two groups was found.
Conclusion
OAGB, as other malabsorbent procedures, appears to have higher rate of cholelithiasis than purely restrictive procedures. In our prospective randomized controlled study, a regular postoperative UDCA intake during the first 6 months seems to significantly reduce cholelithiasis incidence after OAGB, with no case of intolerance reported. Further studies are needed to assess this issue.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04801-z</identifier><identifier>PMID: 32583297</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Gallstones ; Gastric Bypass - adverse effects ; Gastrointestinal surgery ; Humans ; Laparoscopy ; Medicine ; Medicine & Public Health ; Obesity, Morbid - surgery ; Original Contributions ; Prospective Studies ; Quality of Life ; Surgery ; Ursodeoxycholic Acid - therapeutic use</subject><ispartof>Obesity surgery, 2020-11, Vol.30 (11), p.4315-4324</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-bb6341072c43a152e7e21e5005c86ff64b7796d78c4c283d1fd7c9a2cfdd31c33</citedby><cites>FETCH-LOGICAL-c375t-bb6341072c43a152e7e21e5005c86ff64b7796d78c4c283d1fd7c9a2cfdd31c33</cites><orcidid>0000-0001-9785-4405</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04801-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04801-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32583297$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pizza, Francesco</creatorcontrib><creatorcontrib>D’Antonio, Dario</creatorcontrib><creatorcontrib>Lucido, Francesco Saverio</creatorcontrib><creatorcontrib>Tolone, Salvatore</creatorcontrib><creatorcontrib>Del Genio, Gianmattia</creatorcontrib><creatorcontrib>Dell’Isola, Chiara</creatorcontrib><creatorcontrib>Docimo, Ludovico</creatorcontrib><creatorcontrib>Gambardella, Claudio</creatorcontrib><title>The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Introduction
Bariatric surgery leads to rapid weight loss, a well-known risk factor for gallstone formation. Postoperative biliary complication rate requiring cholecystectomy is between 0.9 and 7.5% after laparoscopic sleeve gastrectomy and between 6 and 50% after laparoscopic gastric bypass. Several authors recommended ursodeoxycholic acid (UDCA) administration to reduce gallstone formation after diet-induced weight reduction. The aim of this randomized monocentric study is to evaluate gallstone incidence after prophylactic administration of UDCA in patients undergoing one anastomosis gastric bypass (OAGB).
Methods
Patients undergoing OAGB were prospectively randomized into 2 groups: the UDCA group receiving oral UDCA 600 mg/days for 6 months in the immediate postoperative days, and the control group not administered with UDCA. Each group included 95 patients. Abdominal ultrasound, clinical evaluation, and quality of life scoring with Gastrointestinal Quality of Life Index (GIQLI) were performed postoperatively in all patients at 3, 6, and 12 months.
Results
At 12 months of postoperative follow-up, 4 (4.2%) and 24 patients (25.2%) showed gallstones in the UDCA group and control group, respectively (
p
< 0.05). Among those who developed gallstones, 8 (28.6%) cases were symptomatic whereas 20 (71.4%) did not show any symptom. No statistically significant difference in GIQLI score between the two groups was found.
Conclusion
OAGB, as other malabsorbent procedures, appears to have higher rate of cholelithiasis than purely restrictive procedures. In our prospective randomized controlled study, a regular postoperative UDCA intake during the first 6 months seems to significantly reduce cholelithiasis incidence after OAGB, with no case of intolerance reported. Further studies are needed to assess this issue.</description><subject>Gallstones</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surgery</subject><subject>Ursodeoxycholic Acid - therapeutic use</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc-O0zAQxiMEYsvCC3BAlrh0DwH_SeKEW7awBWlXlar2bDn2ZOuVYxc7kWjfjLfD3S4gceDk8czv-2akL8veEvyBYMw_RkKqpswxxTkuakzy47NsRjiu05fWz7MZbiqc1w1lF9mrGB8wpqSi9GV2wWhZM9rwWfZzswO09haQ79E2RK_B_zionbdGoVYZjebbz4v2ChmHFqkL1ow7I6OJ6E46eQ8DuBG1_QgBrRyg1sk4-sGfgGUqQ7K5PuxljGi-apfXV6j3Ad350CXrVQfRjIdPaA1xsmM83SDT0HmVXE_StXTaD-YIGi18anlrU7kJRtrX2Yte2ghvnt7LbHvzZbP4mt-ult8W7W2uGC_HvOsqVhDMqSqYJCUFDpRAiXGp6qrvq6LjvKk0r1WhaM006TVXjaSq15oRxdhlNj_77oP_PkEcxWCiAmulAz9FQQvCC8waUiT0_T_og5-CS9cJWhUlI02Jq0TRM6WCjzFAL_bBDDIcBMHiFKw4BytSsOIxWHFMondP1lM3gP4j-Z1kAtgZiGnk7iH83f0f21_ZE69k</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Pizza, Francesco</creator><creator>D’Antonio, Dario</creator><creator>Lucido, Francesco Saverio</creator><creator>Tolone, Salvatore</creator><creator>Del Genio, Gianmattia</creator><creator>Dell’Isola, Chiara</creator><creator>Docimo, Ludovico</creator><creator>Gambardella, Claudio</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9785-4405</orcidid></search><sort><creationdate>20201101</creationdate><title>The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial</title><author>Pizza, Francesco ; D’Antonio, Dario ; Lucido, Francesco Saverio ; Tolone, Salvatore ; Del Genio, Gianmattia ; Dell’Isola, Chiara ; Docimo, Ludovico ; Gambardella, Claudio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-bb6341072c43a152e7e21e5005c86ff64b7796d78c4c283d1fd7c9a2cfdd31c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Gallstones</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surgery</topic><topic>Ursodeoxycholic Acid - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pizza, Francesco</creatorcontrib><creatorcontrib>D’Antonio, Dario</creatorcontrib><creatorcontrib>Lucido, Francesco Saverio</creatorcontrib><creatorcontrib>Tolone, Salvatore</creatorcontrib><creatorcontrib>Del Genio, Gianmattia</creatorcontrib><creatorcontrib>Dell’Isola, Chiara</creatorcontrib><creatorcontrib>Docimo, Ludovico</creatorcontrib><creatorcontrib>Gambardella, Claudio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pizza, Francesco</au><au>D’Antonio, Dario</au><au>Lucido, Francesco Saverio</au><au>Tolone, Salvatore</au><au>Del Genio, Gianmattia</au><au>Dell’Isola, Chiara</au><au>Docimo, Ludovico</au><au>Gambardella, Claudio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>30</volume><issue>11</issue><spage>4315</spage><epage>4324</epage><pages>4315-4324</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Introduction
Bariatric surgery leads to rapid weight loss, a well-known risk factor for gallstone formation. Postoperative biliary complication rate requiring cholecystectomy is between 0.9 and 7.5% after laparoscopic sleeve gastrectomy and between 6 and 50% after laparoscopic gastric bypass. Several authors recommended ursodeoxycholic acid (UDCA) administration to reduce gallstone formation after diet-induced weight reduction. The aim of this randomized monocentric study is to evaluate gallstone incidence after prophylactic administration of UDCA in patients undergoing one anastomosis gastric bypass (OAGB).
Methods
Patients undergoing OAGB were prospectively randomized into 2 groups: the UDCA group receiving oral UDCA 600 mg/days for 6 months in the immediate postoperative days, and the control group not administered with UDCA. Each group included 95 patients. Abdominal ultrasound, clinical evaluation, and quality of life scoring with Gastrointestinal Quality of Life Index (GIQLI) were performed postoperatively in all patients at 3, 6, and 12 months.
Results
At 12 months of postoperative follow-up, 4 (4.2%) and 24 patients (25.2%) showed gallstones in the UDCA group and control group, respectively (
p
< 0.05). Among those who developed gallstones, 8 (28.6%) cases were symptomatic whereas 20 (71.4%) did not show any symptom. No statistically significant difference in GIQLI score between the two groups was found.
Conclusion
OAGB, as other malabsorbent procedures, appears to have higher rate of cholelithiasis than purely restrictive procedures. In our prospective randomized controlled study, a regular postoperative UDCA intake during the first 6 months seems to significantly reduce cholelithiasis incidence after OAGB, with no case of intolerance reported. Further studies are needed to assess this issue.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32583297</pmid><doi>10.1007/s11695-020-04801-z</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9785-4405</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Gallstones Gastric Bypass - adverse effects Gastrointestinal surgery Humans Laparoscopy Medicine Medicine & Public Health Obesity, Morbid - surgery Original Contributions Prospective Studies Quality of Life Surgery Ursodeoxycholic Acid - therapeutic use |
| title | The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial |
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