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Use of ursodeoxy cholic acid as a prophylaxis from gall stones after bariatric surgery : a case control study

Introduction: Several studies have shown a strong relation between rapid loss of weight after bariatric surgery and developing gallstones. Some surgeons prescribe ursodeoxycholic acid for prevention of gallstones formation. But major guidelines make no definite statement about postoperative ursodeoxycholic acid as prophylaxis. The aim of this study was to evaluate postoperative use of ursodeoxycholic acid and the gallstones disease development in patients who underwent bariatric surgery. 
Methods: This case-control study was conducted at University Hospital. All patients who underwent bariatric surgery between 2012 to 2017 were included, while patients who had history of cholecystectomy and those with symptomatic gallstones before the surgery were excluded. Data were collected from medical records including age, gender, type of surgery, BMI, ursodeoxycholic acid use, gallstone symptoms, and ultrasound findings before and after the surgery. 
Results: Eighty-two patients were included in this study, 56 (68.3%) were females. Their mean age was 36.9±10.8 and mean BMI was 46.7±8.9. Out of 82 operations, 49 (59.8%) had laparoscopic gastric reduction, while 33 (40.2%) had mini gastric bypass. Ten patients (12.19%) developed symptomatic gall stones disease; 3(3.7%) at 3 months, 4 (4.9%) at 6 months, another three cases at 9, 12, and 18 months. ursodeoxycholic acid use for 6 months showed a statistically significant association with the absence of symptomatic gallstones. But its use for only three months did not show this significant relationship. 
Conclusion: Ursodeoxycholic acid use for 6 months after bariatric surgery was associated with lower incidence of symptomatic gall stones disease.