The use of Ursodesoxicolic Acid in Prevention of Collelitiase After Bariatric Surgery: A Systematic Review of Literature
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Resumo
Morbid obesity is considered a serious public health problem generating high human and financial costs. The situation that promotes the highest morbidity after bariatric surgery is the development of cholelithiasis, especially in the first 6 months. Given this process, ursodeoxycholic acid is increasingly being used in the postoperative period due to a reduction in the rate of cholelithiasis. However, there are discussions of which prophylactic method to use. In this context, a systematic review was performed to evaluate the efficacy and use of ursodeoxycholic acid in preventing cholelithiasis after bariatric surgery. After methodological analysis, 6 articles were selected. These studies suggest that administration of 500 to 1000 mg of UDCA for a period of 6 months, depending on the technique used, is significantly associated with decreased incidence of cholelithiasis, with good adherence, cost-effectiveness and few side effects.
Keywords: Ursodeoxycholic Acid, Cholelithiasis, Bariatric Surgery.
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Referências
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Adams, Lindsay B. et al (2016). Randomized, prospective comparison of ursodeoxycholic acid for the prevention of gallstones after sleeve gastrectomy. Obesity surgery, v. 26, n. 5, p. 990-994;
Coupaye, Muriel et al (2017). Evaluation of incidence of cholelithiasis after bariatric surgery in subjects treated or not treated with ursodeoxycholic acid. Surgery for Obesity and Related Diseases, v. 13, n. 4, p. 681-685;
Della Penna, Andrea et al. (2019). Ursodeoxycholic Acid for 6 Months After Bariatric Surgery Is Impacting Gallstone Associated Morbidity in Patients with Preoperative Asymptomatic Gallstones. Obesity surgery, v. 29, n. 4, p. 1216-1221;
Ferrari, M. A. (2014). Colelitíase em pacientes bariátricos: correlação da perda de peso com a incidência de colelitíase em pacientes após a realização do bypass gastrintestinal. PUCRS Biblioteca Digital de Teses e Dissertações;
Machado, Francisco Heine Ferreira et al. (2019). Ursodeoxycholic acid in the prevention of gallstones in patients subjected to Roux-en-Y gastric bypass. Acta Cir Bras, v. 34, p. 1;
Nabil, Tamer M.; Khalil, Ahmed H.; Gamal, Kareem (2019). Effect of oral ursodeoxycholic acid on cholelithiasis following laparoscopic sleeve gastrectomy for morbid obesity. Surgery for Obesity and Related Diseases;
Sociedade Brasileira de Cirurgia Bariátrica e Metabólica (2018). Número de cirurgias bariátricas no Brasil aumenta 46,7%. Disponivel em: <https://www.sbcbm.org.br/numero-de-cirurgias-bariatricas-no-brasil-aumenta-467/>. Acesso em 08 de novembro de 2019.