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熊去氧胆酸对减重手术后胆石形成的影响:一项更新的荟萃分析。

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta-analysis.

机构信息

Department of Pharmacy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.

The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.

出版信息

Obesity (Silver Spring). 2022 Jun;30(6):1170-1180. doi: 10.1002/oby.23427. Epub 2022 Apr 27.

Abstract

OBJECTIVE

Bariatric surgery increases the risk of postoperative gallstone formation. Many studies have proposed ursodeoxycholic acid (UDCA) as a preventive agent for postoperative gallstone formation. This study aimed to investigate the effect of UDCA on gallstone formation after bariatric surgery in patients without preoperative gallstones.

METHODS

PubMed, the Web of Science, the Cochrane Library, and EBSCO were searched for articles assessing the effect of UDCA on gallstone formation after bariatric surgery. The outcome was the incidence of postoperative gallstones. Odds ratios were used to assess dichotomous variables, and random-effects models were used for statistical analyses.

RESULTS

A total of 18 studies including 4,827 participants met the inclusion criteria. The statistical results showed that the incidence of gallstones in the UDCA group was significantly lower than in the control group. Furthermore, the occurrence of symptomatic gallstones and cholecystectomy was significantly reduced.

CONCLUSIONS

In patients without preoperative gallstones, UDCA can effectively prevent the formation of gallstones after bariatric surgery. In addition, UDCA can significantly reduce the occurrence of symptomatic gallstones and the risk of postoperative cholecystectomy. Doses of 500 to 600 mg/d can be used as a measure to prevent postoperative gallstone formation.

摘要

目的

减重手术会增加术后胆囊结石形成的风险。许多研究提出熊去氧胆酸(UDCA)可作为预防术后胆囊结石形成的药物。本研究旨在探讨 UDCA 对无术前胆囊结石的减重手术后胆囊结石形成的影响。

方法

检索 PubMed、Web of Science、Cochrane 图书馆和 EBSCO 中评估 UDCA 对减重手术后胆囊结石形成影响的文章。结局指标为术后胆囊结石的发生率。采用比值比评估二分类变量,采用随机效应模型进行统计学分析。

结果

共有 18 项研究纳入 4827 名参与者符合纳入标准。统计结果显示,UDCA 组的胆囊结石发生率明显低于对照组,且症状性胆囊结石和胆囊切除术的发生明显减少。

结论

对于无术前胆囊结石的患者,UDCA 可有效预防减重手术后胆囊结石的形成。此外,UDCA 可显著降低症状性胆囊结石的发生和术后胆囊切除术的风险。500~600mg/d 的剂量可作为预防术后胆囊结石形成的措施。

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