SLEEVE GASTREKTOMİ SONRASI FARKLI DOZLARDA URSODEOKSİKOLİK ASİT KULLANIMININ SAFRA TAŞI OLUŞUMUNA ETKİSİ
Öz
Amaç: Laparoskopik Sleeve Gastrektomi (LSG) sonrası safra taşlarının önlenmesinde altı ay boyunca farklı dozlarda ursodeoxycholic acid (UDCA) kullanımının 6. ve 12. aylarda safra taşı oluşumuna etkilerini değerlendirmek. Gereç ve Yöntem: Morbid obezite nedeniyle LSG uygulanan hastaların verileri analiz edildi. 20’şer kişilik üç grup oluşturuldu: Kontrol grubu; LSG sonrası altı ay süreyle UCDA 500 mg/gün ile tedavi edilen Grup I; LSG sonrası altı ay süreyle UCDA 1000 mg/ gün ile tedavi edilen Grup II. Demografik özellikler, eşlik eden hastalıklar, ameliyat öncesi ve sonrası kolesterol ve trigliserit farklılıkları, aşırı kilo kaybı (%EWL), toplam kilo kaybı (%TWL), vücut kitle indeksi (BMI) ve abdominal ultrason (US) verileri ameliyat öncesi ve ameliyattan altı ve 12 ay sonra kolelitiazis (CL) gelişimi değerlendirildi. Bulgular: Olguların 6. ay sonuçlarında kontrol grubunun US sonuçlarında taş tespit oranı Grup II’ye göre anlamlı olarak yüksek bulundu (p=0,001; p<0,01). Kontrol grubu ile Grup I arasında (p=0,149), Grup I ile Grup II arasında (p=0,066) istatistiksel olarak anlamlı fark yoktu. Olguların 12. ay sonuçlarında kontrol grubunun US sonuçlarında taş tespit oranı Grup I ve Grup II’ye göre anlamlı olarak yüksek bulundu (p=0,010; p<0,05). Grup I ve Grup II arasında istatistiksel olarak anlamlı fark yoktu. Sonuç: Bu çalışma sonucunda hastalara LSG sonrası 1000 mg/ gün UDCA verilmesini öneriyoruz.
Anahtar Kelimeler
Kolelitiazis laparoskopik sleeve gastrektomi ursodeoksikolik asit
Kaynakça
- 1. Dittrick GW, Thompson JS, Campos D, Bremers D, Sudan D. Gallbladder pathology in morbid obesity. Obes Surg 2005;15(2):238-42. [CrossRef]
- 2. Fobi MAL, Lee H, Igwe D, Felahy B, James E, Stanczyk M, et al. Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease. Obes Surg 2002;12(3):350-3. [CrossRef]
- 3. Iglézias Brandão de Oliveira C, Adami Chaim E, da Silva BB. Impact of rapid weight reduction on risk of cholelithiasis after bariatric surgery. Obes Surg 2003;13(4):625-8. [CrossRef]
- 4. Sioka E, Zacharoulis D, Zachari E, Papamargaritis D, Pinaka O, Katsogridaki G, et al. Complicated gallstones after laparoscopic sleeve gastrectomy. J Obes 2014;2014:468203. [CrossRef]
- 5. Mendez MA, Monteiro CA, Popkin BM. Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr 2005;81(3):714-21. [CrossRef]
- 6. Stampfer MJ, Maclure KM, Colditz GA, Manson JE, Willett WC. Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr 1992;55(3):652-8. [CrossRef]
- 7. Henao-Morán S, Denova-Gutiérrez E, Morán S, Duque X, Gallegos-Carrillo K, Macías N, et al. Recreational physical activity is inversely associated with asymptomatic gallstones in adult Mexican women. Ann Hepatol 2014;13(6):810-8. [CrossRef]
- 8. Moran S, Milke P, Rodriguez G, Uribe M. Ref: Gallstone formation in obese subjects undergoing a weight reduction diet. Int J Obes Relat Metab Disord 1998;22(3):282-4. [CrossRef]
- 9. Shiffman ML, Sugerman HJ, Kellum JM, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction. Gastroenterology 1992;103(1):214-21. [CrossRef]
- 10. Paumgartner G, Sauerbruch T. Gallstones: pathogenesis. Lancet 1991;338(8775):1117-21. [CrossRef]
- 11. Li VKM, Pulido N, Martinez-Suartez P, Fajnwaks P, Jin HY, Szomstein S, et. al. Symptomatic gallstones after sleeve gastrectomy. Surg Endosc 2009;23(11):2488-92. [CrossRef]
- 12. Yang H, Peterson GM, Roth MP, Marks JW. Risk factors for gallstone formation during rapid weight loss. Dig Dis Sci 1992;37(6):912-8. [CrossRef]
- 13. Zapata R, Severin C, Manriquez M, Valdivieso V. Gallbladder motility and. lithogenesis in obese patients during dietinduced weight loss. Dig Dis Sci 2000;45(2):421-8. [CrossRef]
- 14. Amaral JF, Thompson WR. Gallbladder disease in morbidly obese. Am J Surg 1985;149(4):551-7. [CrossRef]
- 15. Deitel M, Petrov I. Incidence of symptomatic gallstones after bariatric operations. Surg Gynecol Obstet 1987;164(6):549- 52. 16. Uy MC, Talingdan-Te MC, Espinosa WZ, Daez ML, Ong JP. Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: a meta-analysis. Obes Surg 2008;18(12):1532-38. [CrossRef]
- 17. Adams LB, Chang C, Pope J, Kim Y, Liu P, Yates A. Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy. Obes Surg 2016;26(5):990-4. [CrossRef]
- 18. Şen O, Türkçapar AG, Yerdel MA. Cholelithiasis After Sleeve Gastrectomy and Effectiveness of Ursodeoxycholic Acid Treatment. J Laparoendosc Adv Surg Tech A 2020;30(11):1150-2. [CrossRef]
- 19. Magouliotis DE, Tasiopoulou VS, Sioka E, Chatedaki C, Zacharoulis D. Impact of bariatric surgery on metabolic and gut microbiota profile: a systematic review and metaanalysis. Obes Surg 2017;27(5):1345-57. [CrossRef]
- 20. Patel JA, Patel NA, Piper GL, Smith DE, Malhotra G, Colella JJ. Perioperative management of cholelithiasis in patients presenting for laparoscopic Roux-en-Y gastric bypass: have we reached a consensus? Am Surg 2009;75(6):470-6. [CrossRef]
- 21. Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, et al. Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 1988;319(24):1567-72. [CrossRef]
- 22. Sugerman HJ, Brewer WH, Shiffman ML, Brolin RE, Fobi MA, Linner JH, et al. A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric- bypass-induced rapid weight loss. Am J Surg 1995;169(1):91-6. [CrossRef]
- 23. Miller K, Hell E, Lang B, Lengauer E. Gallstone formation prophylaxis after gastric restrictive procedures for weight loss: a randomized double-blind placebo-controlled trial. Ann Surg 2003;238(5):697-702. [CrossRef]
- 24. Manatsathit W, Leelasinjaroen P, Al-Hamid H, Szpunar S, Hawasli A. The incidence of cholelithiasis after sleeve gastrectomy and its association with weight loss: A twocentre retrospective cohort study. Int J Surg 2016;30:13-8. [CrossRef]
- 25. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver spring) 2009;17(Suppl 1):S1-70.
- 26. Moon RC, Teixeira AF, DuCoin C, Varnadore S, Jawad MA. Comparison of cholecystectomy cases after Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric banding. Surg Obes Relat Dis 2014;10(1):64-8. [CrossRef]
- 27. Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 1991;86(8):1000-5.
THE EFFECT OF USE OF DIFFERENT DOSES OF URSODEOXYCOLIC ACID ON GALLSTONE FORMATION AFTER SLEEVE GASTRECTOMY
Öz
Objective: To evaluate the effects of using different doses of ursodeoxycholic acid (UDCA) for six months in prevention of gallstones after Laparoscopic Sleeve Gastrectomy (LSG) on the formation of gallstones in the 6th and 12th months. Materials and Methods: The data of patients who underwent LSG for morbid obesity were analyzed. Three groups of 20 people were formed. These were the control group, Group I who were treated with UCDA 500 mg/day for six months after LSG, and Group II who were treated with UCDA 1000 mg/day for 6 months after LSG. Demographic characteristics, co-morbid diseases, cholesterol and triglyceride differences before and after surgery, excess weight loss (EWL%), total weight loss (TWL%), body mass index (BMI), and abdominal ultrasound (US) data for the occurrence of cholelithiasis (CL) preoperatively and at six and 12 months after surgery were collected. Results: The results of tests taken on these patients in the sixth month revealed that the stone detection rate in the US results of the control group was significantly higher than that in Group II (p=0.001; p<0.01). There was no statistically significant difference between the control group and Group I (p=0.149), and between Group I and Group II (p=0.066). The results of tests taken in the 12th month showed that the stone detection rate in the US results of the control group was significantly higher than Group I and Group II (p=0.010; p<0.05). There was no statistically significant difference between Group I and Group II. Conclusion: As a result of this study, we recommend that patients be given 1000 mg/day UDCA after LSG.
Anahtar Kelimeler
Cholelithiasis laparoscopic sleeve gastrectomy ursodeoxycholic acid
Kaynakça
- 1. Dittrick GW, Thompson JS, Campos D, Bremers D, Sudan D. Gallbladder pathology in morbid obesity. Obes Surg 2005;15(2):238-42. [CrossRef]
- 2. Fobi MAL, Lee H, Igwe D, Felahy B, James E, Stanczyk M, et al. Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease. Obes Surg 2002;12(3):350-3. [CrossRef]
- 3. Iglézias Brandão de Oliveira C, Adami Chaim E, da Silva BB. Impact of rapid weight reduction on risk of cholelithiasis after bariatric surgery. Obes Surg 2003;13(4):625-8. [CrossRef]
- 4. Sioka E, Zacharoulis D, Zachari E, Papamargaritis D, Pinaka O, Katsogridaki G, et al. Complicated gallstones after laparoscopic sleeve gastrectomy. J Obes 2014;2014:468203. [CrossRef]
- 5. Mendez MA, Monteiro CA, Popkin BM. Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr 2005;81(3):714-21. [CrossRef]
- 6. Stampfer MJ, Maclure KM, Colditz GA, Manson JE, Willett WC. Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr 1992;55(3):652-8. [CrossRef]
- 7. Henao-Morán S, Denova-Gutiérrez E, Morán S, Duque X, Gallegos-Carrillo K, Macías N, et al. Recreational physical activity is inversely associated with asymptomatic gallstones in adult Mexican women. Ann Hepatol 2014;13(6):810-8. [CrossRef]
- 8. Moran S, Milke P, Rodriguez G, Uribe M. Ref: Gallstone formation in obese subjects undergoing a weight reduction diet. Int J Obes Relat Metab Disord 1998;22(3):282-4. [CrossRef]
- 9. Shiffman ML, Sugerman HJ, Kellum JM, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction. Gastroenterology 1992;103(1):214-21. [CrossRef]
- 10. Paumgartner G, Sauerbruch T. Gallstones: pathogenesis. Lancet 1991;338(8775):1117-21. [CrossRef]
- 11. Li VKM, Pulido N, Martinez-Suartez P, Fajnwaks P, Jin HY, Szomstein S, et. al. Symptomatic gallstones after sleeve gastrectomy. Surg Endosc 2009;23(11):2488-92. [CrossRef]
- 12. Yang H, Peterson GM, Roth MP, Marks JW. Risk factors for gallstone formation during rapid weight loss. Dig Dis Sci 1992;37(6):912-8. [CrossRef]
- 13. Zapata R, Severin C, Manriquez M, Valdivieso V. Gallbladder motility and. lithogenesis in obese patients during dietinduced weight loss. Dig Dis Sci 2000;45(2):421-8. [CrossRef]
- 14. Amaral JF, Thompson WR. Gallbladder disease in morbidly obese. Am J Surg 1985;149(4):551-7. [CrossRef]
- 15. Deitel M, Petrov I. Incidence of symptomatic gallstones after bariatric operations. Surg Gynecol Obstet 1987;164(6):549- 52. 16. Uy MC, Talingdan-Te MC, Espinosa WZ, Daez ML, Ong JP. Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: a meta-analysis. Obes Surg 2008;18(12):1532-38. [CrossRef]
- 17. Adams LB, Chang C, Pope J, Kim Y, Liu P, Yates A. Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy. Obes Surg 2016;26(5):990-4. [CrossRef]
- 18. Şen O, Türkçapar AG, Yerdel MA. Cholelithiasis After Sleeve Gastrectomy and Effectiveness of Ursodeoxycholic Acid Treatment. J Laparoendosc Adv Surg Tech A 2020;30(11):1150-2. [CrossRef]
- 19. Magouliotis DE, Tasiopoulou VS, Sioka E, Chatedaki C, Zacharoulis D. Impact of bariatric surgery on metabolic and gut microbiota profile: a systematic review and metaanalysis. Obes Surg 2017;27(5):1345-57. [CrossRef]
- 20. Patel JA, Patel NA, Piper GL, Smith DE, Malhotra G, Colella JJ. Perioperative management of cholelithiasis in patients presenting for laparoscopic Roux-en-Y gastric bypass: have we reached a consensus? Am Surg 2009;75(6):470-6. [CrossRef]
- 21. Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, et al. Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 1988;319(24):1567-72. [CrossRef]
- 22. Sugerman HJ, Brewer WH, Shiffman ML, Brolin RE, Fobi MA, Linner JH, et al. A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric- bypass-induced rapid weight loss. Am J Surg 1995;169(1):91-6. [CrossRef]
- 23. Miller K, Hell E, Lang B, Lengauer E. Gallstone formation prophylaxis after gastric restrictive procedures for weight loss: a randomized double-blind placebo-controlled trial. Ann Surg 2003;238(5):697-702. [CrossRef]
- 24. Manatsathit W, Leelasinjaroen P, Al-Hamid H, Szpunar S, Hawasli A. The incidence of cholelithiasis after sleeve gastrectomy and its association with weight loss: A twocentre retrospective cohort study. Int J Surg 2016;30:13-8. [CrossRef]
- 25. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver spring) 2009;17(Suppl 1):S1-70.
- 26. Moon RC, Teixeira AF, DuCoin C, Varnadore S, Jawad MA. Comparison of cholecystectomy cases after Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric banding. Surg Obes Relat Dis 2014;10(1):64-8. [CrossRef]
- 27. Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 1991;86(8):1000-5.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ARAŞTIRMA |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Ocak 2022 |
| Gönderilme Tarihi | 8 Haziran 2021 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 85 Sayı: 1 |
Kaynak Göster
Contact information and address
Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE
Email: itfdergisi@istanbul.edu.tr
Phone: +90 212 414 21 61