BACKGROUND Rapid weight loss is associated with a high incidence of cholelithiasis. OBJECTIVES To identify the incidence of gallstone formation after weight loss surgery and to detect the efficacy of 6 months regimen of prophylactic Ursodeoxycholic acid (UDCA). METHODS RCT included a total of 1530 morbid obese patients who were subjected to either laparoscopic one anastomosis gastric bypass (OAGB), sleeve gastrectomy (SG), or greater curve plication (GCP). Patients with previous or concomitant cholecystectomy and missed follow-up were excluded, leaving 1432 patients to analyze. They were randomly allocated into two groups receiving either UDCA or placebo with a minimum follow-up of one year for assessment of cholelithiasis and weight loss. RESULTS The overall incidence of cholelithiasis after surgery was 9.7%. There was a significant decrease in the incidence of gallstone formation from 22% in placebo to 6.5% in treated group with UDCA. The mean percentage of excess weight loss (%EWL) was significantly higher in those who develop gallstones than others. Of those developing gallstones, there was 64.7 % with SG versus 28.1% and 7.2% in OAGB and GCP, respectively, which is statistically significant. NNT to prevent cholelithiasis is six, AR% is 70.4%, and RR is 3.4%. CONCLUSIONS Cholelithiasis after SG and OAGB was higher than GCP. %EWL was rapid and higher in OAGB and SG contributing to the higher rate of symptomatic cholelithiasis and could be predictive for post-bariatric cholelithiasis. A 6-month use of UDCA is an effective prophylaxis decreasing gallstone formation after bariatric surgery at short-term follow-up.

中文翻译：

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减肥手术后的胆石症，发生率和预防：随机对照试验。

背景技术快速的体重减轻与胆石症的高发病率有关。目的确定减肥手术后胆结石形成的发生率，并检测6个月的预防性熊去氧胆酸（UDCA）方案的疗效。方法RCT包括总共1530例病态肥胖患者，他们接受了腹腔镜一次吻合术胃旁路手术（OAGB），袖式胃切除术（SG）或更大弯曲术（GCP）。排除了先前或同时进行的胆囊切除术和随访遗漏的患者，剩下1432例患者需要分析。将他们随机分为两组，接受UDCA或安慰剂，至少随访一年，以评估胆石症和体重减轻。结果术后胆石症的总发生率为9.7％。UDCA治疗组的胆结石形成发生率从安慰剂组的22％降至6.5％。胆结石形成者的平均多余体重减轻百分比（％EWL）明显高于其他人。在这些发展中的胆结石中，SG占64.7％，而OAGB和GCP分别为28.1％和7.2％，这在统计学上是显着的。预防胆石症的NNT为6，AR％为70.4％，RR为3.4％。结论SG和OAGB术后胆石症高于GCP。OAGB和SG中的％EWL快速且较高，这导致症状性胆石症的发生率更高，并且可以预示重症后胆石症。在短期随访中，使用UDCA 6个月可有效减少肥胖手术后胆结石的形成。