Impact of Ursodiol on Number of Cholecystectomies Performed After Bariatric Surgery

The risk of gallstone formation is greater in obese patients; paradoxically, the rapid weight loss after bariatric surgery (BS) is also a great contributor to cholelithiasis and biliary disease. While concomitant cholecystectomy has been used to mitigate this issue, the demand for a less invasive prophylaxis was met by ursodeoxycholic acid (UDCA). This study aims to evaluate the impact of UDCA on the incidence of cholecystectomies after BS.

This retrospective chart review included all primary and revisional bariatric procedures. Patients were divided into 2 groups based on the postoperative use of daily 600 mg UDCA for 6 months (group 2) or no UDCA use (group 1) to assess its impact on the incidence of cholecystectomy. A subanalysis compared baseline demographics, weight loss performance, and the number of cholecystectomies between groups.

In a cohort of 8433 patients, 5061 were in group 1, and 3372 were in group 2 who received UDCA. The total number of cholecystectomies after BS was 164 (1.9% of the cohort): 146 in group 1 (2.9%) and 18 in group 2 (0.5%) ( P <0.00). A subanalysis revealed no significant differences in preoperative weight, body mass index (BMI), and postoperative total body weight loss (TBWL%) between the groups. Nonetheless, incidences of cholecystectomy after biliopancreatic diversion with duodenal switch (BPD-DS), Roux-en-Y Gastric Bypass (RYGB), and sleeve gastrectomy (SG) were greater in group 1, 8% versus 1.4%, 4.4% versus 0.1%, and 1.7% versus 0.4%, respectively (all P <0.05).

UDCA is associated with lower incidence rates of cholecystectomy after BS.