Effectiveness of ursodeoxycholic acid for the treatment ofgall bladder stones and sludge in pregnant women

Effectiveness of ursodeoxycholic acid for the treatment ofgall bladder stones and sludge in pregnant women

Aim: The objective of this study is to evaluate the effectiveness of ursodeoxycholic acid (UDCA) for the treatment of symptomaticpregnant women with gall bladder stones and/or sludge.Materials and Methods: Gynecology and obstetrics clinic patients who were symptomatic with gallbladder stones and/ormicrolithiasis were included in the study. Group 1 consisted of cases with conservative treatment and group 2 consisted of caseswith UDCA treatment. After treatment, the groups were compared for symptomatic and radiological relief and hospitalization.Results: For group 2, the mean treatment time with UDCA was 7.6 weeks. After treatment, a full cure was achieved in 28% of casesand symptomatic relief was achieved in 36% of cases. In group one; there was response to treatment in only 12% of cases. Inthe UDCA group, none of the patients needed hospitalization; however, in the conservative treatment group, five cases neededhospitalization.Conclusion: UDCA is effective for the treatment of symptomatic gall bladder disease in pregnancy. It both relieves symptoms anddecreases the need for hospitalization.

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  • 1. de Bari O, Wang TY, Liu M, et al. Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment. Ann Hepatol 2014;13:728- 45.
  • 2. Xiao ZL, Chen Q, Biancani P, et al. Mechanisms of gallbladder hypomotility in pregnant guinea pigs. Gastroenterology. 1999;116:411-9.
  • 3. Bolukbas FF, Bolukbas C, Horoz M, et al. Risk factors associated with gallstone and biliary sludge formation during pregnancy. J Gastroenterol Hepatol 2006;21:1150-3.
  • 4. del Avila-Silva MR, Zavala-Castillo JC, Coronel-Cruz FM. Laparoscopic cholecystectomy in pregnant patient: experience in hospital General de Mexico in a period of 5 years (2008-2012). Ginecol Obstet Mex 2014;82:509-17.
  • 5. Ramin KD, Ramsey PS. Disease of the gallbladder and pancreas in pregnancy. Obstet Gynecol Clin North Am 2001;28:571-80.
  • 6. Guarino MP, Cong P, Cicala M, et al. Ursodeoxycholic acid improves muscle contractility and inflammation in symptomatic gallbladders with cholesterol gallstones. Gut 2007;56:815-20.
  • 7. I'lchenko AA, Orlova IuN. Effectiveness of ursodeoxycholic acid in cholesterosis of the gallbladder. Ter Arkh 2003;75:35-8.
  • 8. Bouyou J, Gaujoux S, Marcellin L, et al. Abdominal emergencies during pregnancy. J Visc Surg 2015;152:105-15.
  • 9. Ibitoye BO, Adisa AO, Makinde ON, et al. Prevalence and complications of gallstone disease among pregnant women in a Nigerian hospital. Int J Gynaecol Obstet 2014;125:41-3.
  • 10. Jorge AM, Keswani RN, Veerappan A, et al. Non-operative management of smymptomatic cholelithiasis in pregnancy is associated with frequent hospitalizations. J Gastrointest Surg. 2015;19:598- 603.
  • 11. Othman MO, Stone E, Hashimi M, et al. Conservative management of cholelithiasis and its complications in pregnancy is associated with recurrent symptoms and more emergency department visits. Gastrointest Endosc 2012;76:564-9.
  • 12. Kuy S, Roman SA, Desai R, et al. Outcomes following cholecystectomy in pregnant and nonpregnant women. Surgery 2009;146:358-66.
  • 13. Abate MA. Medical management of cholesterol gallstones. Drug Intell Clin Pharm 1986;20:106-15. 14. Salen G. Clinical perspective on the treatment of gallstones with ursodeoxycholic acid. J Clin Astronautical 1988;10:12-7.
  • 15. O'Donnell LD, Heaton KW. Recurrence and rerecurrence of gall stones after medical dissolution: a longterm follow up. Gut 1988;29:655-8.
  • 16. Mijnhout GS, Smulders YM, Craanen ME. Gallstones following considerable weight loss and recommendations for their prevention. Ned Tijdschr Geneeskd 2004;148:174-7.
  • 17. Adams LB, Chang C, Pope J, et al. Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy. Obes Surg 2016;26:990-4
  • 18. Stokes CS, Gluud LL, Casper M, et al. Ursodeoxycholic acid and diets higher in fat prevent gallbladder stones during weight loss: a meta-analysis of randomized controlled trials. Clin Gastroenterol Hepatol 2014;12:1090-100.
  • 19. Nishizawa T, Suzuki H, Takahashi M, et al. Effect of ursodeoxycholic acid and endoscopic sphincterotomy in long-term stenting for common bile duct stones. J Gastroenterol Hepatol 2013;28:63-7.
  • 20. Guarino MP, Carotti S, Sarzano M, et al. Short-term ursodeoxycholic acid treatment improves gallbladder bile turnover in gallstone patients: a randomized trial. Neurogastroenterol Motil 2005;17:680-6.
  • 21. Venneman NG, Besselink MG, Keulemans YC, et al. Ursodeoxycholic acid exerts no beneficial effect in patients with symptomatic gallstones awaiting cholecystectomy. Hepatology 2006;43:1276-83.
  • 22. Joutsiniemi T, Timonen S, Linden M, et al. Intrahepatic cholestasis of pregnancy: observational study of the treatment with low-doseursodeoxycholic acid. BMC Gastroenterol 2015;15:92.
  • 23. Grymowicz M, Czajkowski K, Smolarczyk R. Pregnancy course in patients with intrahepatic cholestasis of pregnancy treated with very low doses of ursodeoxycholic acid. Scand J Gastroenterol 2016;51:78-85.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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