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Prevention of gallstones by ursodeoxycholic acid after cardiac surgery

Toshiji Ai1, Ryosaku Azemoto, Hiromitsu Saisho

  • 1Division of Gastroenterology, Chiba Cardiovascular Center, 575 Tsurumai, 290-0512, Ichihara, Japan.

Journal of Gastroenterology
|December 16, 2003
PubMed

Insights

Ursodeoxycholic acid (UDCA) effectively prevents gallstone formation in patients undergoing open cardiac surgery. Prophylactic UDCA significantly reduced gallstone incidence over 60 months in this study.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Surgical Innovation

Background:

  • Gallstone formation is a known complication in patients with prosthetic heart valves.
  • The use of cardiopulmonary bypass (heart-lung machine) during cardiac surgery is suspected to contribute to gallstone development.
  • Ursodeoxycholic acid (UDCA) is investigated for its potential to prevent gallstones post-cardiac surgery.

Purpose of the Study:

  • To evaluate the efficacy of ursodeoxycholic acid (UDCA) in preventing gallstone formation after open cardiac surgery.
  • To assess the long-term impact of UDCA prophylaxis on gallstone incidence in cardiac surgery patients.

Main Methods:

  • A randomized controlled trial involving 106 patients undergoing cardiac surgery with a heart-lung machine.
  • Patients were divided into two groups: one receiving UDCA (600 mg daily for 6 months) and a control group.
  • Ultrasonography monitored gallstone formation for 60 months, with blood markers of hemolysis assessed at various intervals.

Main Results:

  • The cumulative incidence of gallstones was significantly lower in the UDCA group (0-8.4%) compared to the control group (15.1-29.2%) over 60 months.
  • No gallstones were observed in the UDCA group at 3 and 6 months post-surgery.
  • The gallstones formed in the control group were primarily black pigment stones.

Conclusions:

  • Prophylactic administration of ursodeoxycholic acid (UDCA) significantly reduces the incidence of gallstones following open cardiac surgery.
  • UDCA appears to be an effective preventive measure against gallstone formation in this patient population.
  • The findings support the use of UDCA to mitigate a common post-surgical complication.
Abstract

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