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Al-Huniti M, Alsardia Y, Odeh A, Bdour B, Hassanat R, Aloun A, Sha'ban BW, Nseirat SM. Ursodeoxycholic Acid Prophylaxis and the Reduction of Gallstone Formation After Bariatric Surgery: An Updated Meta-Analysis of Randomized Controlled Trials. Cureus 2023; 15:e50649. [PMID: 38229797 PMCID: PMC10790195 DOI: 10.7759/cureus.50649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/18/2024] Open
Abstract
Gallstone formation following bariatric surgery poses a significant clinical concern, prompting various preventive strategies, including ursodeoxycholic acid (UDCA) prophylaxis. This systematic review and meta-analysis aimed to assess the efficacy of UDCA in preventing gallstone formation after bariatric surgery. A comprehensive literature search was conducted in major databases up to September 2023, identifying 12 randomized controlled trials (RCTs) meeting the inclusion criteria. The studies, spanning from 1993 to 2022, involved 2,767 patients who underwent diverse bariatric procedures. The primary outcome was the overall incidence of cholelithiasis, with secondary outcomes encompassing gallstone occurrences at three, six, and 12 months; symptomatic cholelithiasis; and rates of cholecystectomy. The Cochrane risk-of-bias tool was utilized for evaluating study quality, and statistical analyses were conducted using the RevMan software (Cochrane Collaboration, London, UK). Patients receiving UDCA demonstrated a significantly lower overall incidence of gallstones post-bariatric surgery (risk ratio [RR] 0.13; P < 0.0001). Subgroup analyses confirmed reduced gallstone incidence at three months (P = 0.04), six months (P < 0.00001), and one year (P < 0.00001) with UDCA prophylaxis. Symptomatic cholelithiasis incidence was also lower in the UDCA group (RR 5.70; P < 0.00001), and cholecystectomy rates were significantly reduced (RR 3.05; P = 0.002). This meta-analysis supports the efficacy of UDCA prophylaxis in preventing gallstone formation after bariatric surgery. The findings suggest that UDCA administration not only lowers overall gallstone incidence but also reduces the occurrence of symptomatic cholelithiasis and mitigates the need for cholecystectomy. However, caution is warranted due to heterogeneity, diverse surgical procedures, and limited long-term follow-up in the included studies. Further research with standardized protocols and extended observational periods is recommended to strengthen the evidence base and guide clinical practice.
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Affiliation(s)
- Mohammad Al-Huniti
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Yousef Alsardia
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Alaa Odeh
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Belal Bdour
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Ramadan Hassanat
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Ali Aloun
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Ban W Sha'ban
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
| | - Sara M Nseirat
- Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR
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Joukar F, Ashoobi MT, Alizadeh A, Zeinali T, Faraji N, Tabatabaii M, Mansour-Ghanaei R, Naghipour M, Mansour-Ghanaei F. The association between the volume of the gallbladder based on sonographic findings and demographical data in the PERSIAN Guilan cohort study (PGCS). BMC Res Notes 2023; 16:310. [PMID: 37924103 PMCID: PMC10623732 DOI: 10.1186/s13104-023-06582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/18/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Ultrasound is an important method to determine the volume of the gallbladder and check its structure. Considering the variation in the size and volume of the gallbladder in disease and physiological conditions, determining the volume of the gallbladder is clinically valuable. This study was carried out to evaluate the gallbladder volume and its association with patients' demographic data in the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS) population. METHODS In this cross-sectional study, 957 individuals aged 35-70 participated in determining the gallbladder volume by a radiologist based on the ultrasound method. The demographical data were collected using a questionnaire. After fasting for 12 h, the ultrasound was performed with an Ultrasonic device (Sonix SP series) with a 3.5 to 5 MHz probe. RESULTS The total frequency of gallbladder lesions was 2.2%. The results showed a significant association between marriage and gender with the presence or absence of lesions in the studied participants (P < 0.05). Also, significant differences were reported between the volume of gallbladder and gender, body mass index (BMI), social and economic status (SES), metabolic equivalent of task (MET), history of cardiovascular disease (CVD), and hypertension (P < 0.05). The results of a linear regression represented a significant association between gender, BMI, MET, and CVD and the mean volume of the gallbladder (P < 0.05). However, there was no significant association between the presence or absence of a lesion and the individuals' average gallbladder volume (P > 0.05). CONCLUSION According to our results, gender, BMI, MET, and CVD were significantly associated with gallbladder volume.
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Affiliation(s)
- Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Taghi Ashoobi
- Department of Surgery, School of Medicine Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Ahmad Alizadeh
- Department of Radiology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Tahereh Zeinali
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Niloofar Faraji
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadjavad Tabatabaii
- Department of Radiology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Roya Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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Salari N, Hasheminezhad R, Heidarisharaf P, Khaleghi AA, Azizi AH, Shohaimi S, Mohammadi M. The global prevalence of gallstones in pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X 2023; 19:100237. [PMID: 37711873 PMCID: PMC10497987 DOI: 10.1016/j.eurox.2023.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/16/2023] [Accepted: 09/02/2023] [Indexed: 09/16/2023] Open
Abstract
Background Gallstone disease is the second most common non-gynecological disease that may require surgical intervention during pregnancy. This study investigates the global prevalence of gallstones in pregnancy through a systematic review and meta-analysis. Methods A systematic review and meta-analysis of studies that reported the global prevalence of gallstones in pregnancy was conducted. PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar were searched for studies published up to September 2022. Results In a review of 31 studies with a sample size of 190,714 people, the I2 heterogeneity test showed high heterogeneity (I2 = 98.8%). Therefore, the random effects method was used to analyze the results. The prevalence of gallstones was reported as 3.6% (95% CI: 1.9-6.7%). The highest prevalence of gallstones by continent was reported in America, at 6.8% (95% CI: 4.2-10.8%). The Egger test showed no evidence of publication bias (p = 0.609). Conclusion Based on the results of this study, health policymakers should emphasize to the target community and the medical staff dealing with pregnant women the importance of screening for gallstones during pregnancy.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Razie Hasheminezhad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Ali Asghar Khaleghi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | | | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
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Azadbakht S, Parvaee R, Darabian S. An epidemiological investigation of gallstone disease among patients admitted to Shahid Rahimi teaching hospital in Khorramabad in 2016-2020. Afr Health Sci 2023; 23:435-441. [PMID: 38223601 PMCID: PMC10782301 DOI: 10.4314/ahs.v23i2.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Background Gallstones are a significant global health issue, imposing enormous costs to patients and the healthcare system, annually. Objectives This epidemiological study aimed to explore the prevalence of gallstones among inpatients who were admitted to Shahid Rahimi Hospital in Khorramabad City, Iran, from 2016 to 2020. Methods This was a retrospective and descriptive-analytical study. The study population included patients who were admitted to Shahid Rahimi Hospital in Khorramabad City, Iran, who underwent abdominal ultrasounds from 2016 to 2020. The required data were collected using a checklist and patients' records. The logistic regression analysis method was used to analyse the obtained data in SPSS at the significance level of P<0.05. Results Of the 927 explored subjects, 232(25%) presented gallstones. The mean age of the patients with gallstones was 62.9 years. The most frequent symptom in individuals with gallstones was right upper quadriceps abdominal pain (63%). There was a significant relationship between gallstone and age, gender, epigastric pain, upper quadrant pain, hypertension, anemia, and family history. Conclusion The present study findings indicated that increasing age, female gender, the lack of epigastric pain, upper quadrant pain, anemia, hypertension, and a family history of this disease increased the risk of generating gallstone disease.
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Affiliation(s)
- Saleh Azadbakht
- Department of Internal Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Raziyeh Parvaee
- Student Research Committee, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Samad Darabian
- Department of Statistics and Epidemiology, School of Health, Lorestan University of Medical Sciences, Khorramabad, Iran
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Silva DAGDA, Veloso OLL, Valadares MSP, Costa RSDA, Silveira MG, Carvalho FCDE, Sousa MG. Incidental gallbladder cancer: what is the prevalence and how do we perform cholecystectomy for presumably benign biliary disease? Rev Col Bras Cir 2023; 49:e20223417. [PMID: 36629721 PMCID: PMC10578791 DOI: 10.1590/0100-6991e-20223417-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE to determine the prevalence of incidental gallbladder cancer (IGBC) in cholecystectomies performed in a tertiary public hospital and to describe technical and epidemiological aspects of performing cholecystectomies for presumably benign disease. METHOD descriptive, retrospective observational study, based on analysis of medical records of patients undergoing cholecystectomy with preoperative hypothesis of benign disease between January 2018 and January 2022. RESULTS prevalence of gallbladder adenocarcinoma in our sample was 0.16%, similar to data in the literature. Technical aspects during cholecystectomy were also described with a frequency similar to that found in the literature. CONCLUSION despite a rare disease, IGBC is relevant in the routine of the General Surgeon. Its diagnosis, staging and treatment directly affect the prognosis. Technical aspects during cholecystectomy are not always remembered by surgeons and can interfere with the prognosis and subsequent treatment of the patient.
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Affiliation(s)
- Diego Arley Gomes DA Silva
- - Universidade Federal da Paraíba, Departamento de Cirurgia - João Pessoa - PB - Brasil
- - Instituto do Coração do Hospital das Clínicas da FMUSP, Disciplina de Cirurgia Torácica - São Paulo - SP - Brasil
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SILVA DIEGOARLEYGOMESDA, VELOSO OLGALANUSALEITE, VALADARES MATHEUSSOUTOPERAZZO, COSTA RODRIGOSOARESDA, SILVEIRA MARIANAGALINDO, CARVALHO FERNANDACOSTADE, SOUSA MARCELOGONÇALVES. Câncer incidental de vesícula biliar: qual a prevalência e como operamos a colecistectomia por doença presumidamente benigna? Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RESUMO Objetivos: determinar a prevalência de câncer incidental de vesícula biliar (CIVB) em colecistectomias realizadas em um hospital público terciário e descrever aspectos técnicos e epidemiológicos na realização de colecistectomias por doença presumidamente benigna. Método: estudo observacional descritivo, retrospectivo, a partir da análise de prontuários de pacientes submetidos à colecistectomia com hipótese pré-operatória de doença benigna entre janeiro de 2018 e janeiro de 2022. Resultados: a prevalência de adenocarcinoma de vesícula biliar na amostra avaliada foi de 0,16%, semelhante aos dados da literatura mundial. Os aspectos técnicos durante a realização da colecistectomia também foram descritos com frequência semelhante ao encontrado na literatura. Conclusão: o CIVB é uma doença rara mas de importância relevante na rotina do Cirurgião Geral. Seu diagnóstico, estadiamento e tratamento implicam diretamente no prognóstico. Aspectos técnicos durante a realização da colecistectomia nem sempre são lembrados pelos cirurgiões e podem interferir no prognóstico e tratamento subsequente do paciente.
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Tumwine JK. Reproductive health issues, infections and non-communicable diseases. Afr Health Sci 2020; 20:I-IV. [PMID: 33402945 PMCID: PMC7750065 DOI: 10.4314/ahs.v20i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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