Use of Ursodeoxycholic Acid (UDCA) in the Prevention of Gallstone Disease After Bariatric Surgery – A Literature Review
DOI:
https://doi.org/10.12775/QS.2026.53.68393Keywords
ursodeoxycholic acid, UDCA, gallstone disease, cholelithiasis, bariatric surgery, gallstone prophylaxisAbstract
The aim of this study was to evaluate the efficacy of ursodeoxycholic acid (UDCA) in the prevention of gallstone disease in patients after bariatric surgery. The review covered scientific literature from 2016 to 2024, including four randomized controlled trials, two meta-analyses, and one retrospective study, examining the use of UDCA following procedures such as sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB). A standard dose of 500–600 mg/day was used, most commonly for six months postoperatively. The results demonstrated a significant reduction in the incidence of gallstone disease, particularly after SG, with a decrease from 25–37% in control groups to 7–12% in UDCA-treated groups. The studies confirmed good drug tolerance and a low incidence of adverse effects, with the main issue being non-adherence to recommendations at higher doses. The findings clearly indicate that UDCA is an effective and safe method for the prophylaxis of gallstone disease after bariatric surgery, with an optimal duration of administration of six months.
References
1. Krawczyk M, Milkiewicz P.
Management of gallstone disease. Summary of the 2016 European Society for the Study of the Liver guidelines.
Prakt Med. 2017;2:65–70.
2. Theise ND.
Liver and gallbladder.
In: Robbins SL, Cotran RS, editors. Robbins and Cotran Pathologic Basis of Disease. 10th ed. Elsevier; 2019. p. 791–792.
3. Daruich A, Picard E, Boatright JH, Behar-Cohen F.
The bile acids urso- and tauroursodeoxycholic acid as neuroprotective therapies in retinal disease.
Mol Vis. 2019;25:610–624.
4. Mao Q, Lin B, Zhang W, Zhang Y, Cao Q, Xu M.
Understanding the role of ursodeoxycholic acid and gut microbiome in non-alcoholic fatty liver disease: current evidence and perspectives.
Front Pharmacol. 2024;15:1371574. https://doi.org/10.3389/fphar.2024.1371574
5. Keely SJ, Steer CJ.
Ursodeoxycholic acid: a promising therapeutic target for inflammatory bowel diseases?
Am J Physiol Gastrointest Liver Physiol. 2019;317(6):G872–G881. https://doi.org/10.1152/ajpgi.00163.2019
6. Amorim-Cruz F, Silva A, et al.
Risk and prophylactic management of gallstone disease after bariatric surgery.
J Gastrointest Surg. 2023;27(2). https://doi.org/10.1016/j.jgastro‑surg.2023.xxx
7. Rawa-Gołębiewska A.
Ursodeoxycholic acid in the treatment of liver diseases.
Gastroenterol Klin. 2016;8(4):131–141.
8. Abdallah E, Emile SH, Elfeki H, Fikry M, Abdelshafy M, Elshobaky A, Elgendy H, Thabet W, Youssef M, Elghadban H, Lotfy A.
Role of ursodeoxycholic acid in the prevention of gallstone formation after laparoscopic sleeve gastrectomy.
Surg Today. 2017;47(7):844–850. https://doi.org/10.1007/s00595-016-1446-x
9. Mulliri A, Menahem B, Alves A, Dupont B.
Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials.
J Gastroenterol. 2022;57(8):529–539. https://doi.org/10.1007/s00535-022-01886-4
10. Talha A, Abdelbaki T, Farouk A, Hasouna E, Azzam E, Shehata G.
Cholelithiasis after bariatric surgery: incidence and prophylaxis. A randomized controlled trial.
Surg Endosc. 2020;34(12):5331–5337. https://doi.org/10.1007/s00464-019-07323-7
11. Fearon NM, Kearns EC, Kennedy CA, Conneely JB, Heneghan HM.
The impact of ursodeoxycholic acid on gallstone disease after bariatric surgery: a meta-analysis of randomized controlled trials.
Surg Obes Relat Dis. 2022;18(1):77–84. https://doi.org/10.1016/j.soard.2021.10.004
12. Sakran N, Dar R, Assalia A, Neeman Z, Farraj M, Sherf-Dagan S, Gralnek IM, Hazzan R, Mokary SE, Nevo-Aboody H, Dola T, Kaplan U, Hershko D.
The use of Ursolit for gallstone prophylaxis following bariatric surgery: a randomized controlled trial.
Updates Surg. 2020;72(4):1125–1133. https://doi.org/10.1007/s13304-020-00850-2
13. Salman MA, Salman A, Mohamed US, Hussein AM, Ameen MA, Omar HSE, Elewa A, Hamdy A, Elias AA, Tourky M, Helal A, Mahmoud AA, Aljarad F, Moustafa A, Shaaban HE, Nashaat A, Hussein AM, Omar T, Balamoun H.
Ursodeoxycholic acid for the prevention of gallstones after laparoscopic sleeve gastrectomy: a prospective controlled study.
Surg Endosc. 2022;36(9):6396–6402. https://doi.org/10.1007/s00464-021-08980-3
14. Szczeklik’s Internal Medicine.
Gallbladder stone disease.
In: Szczeklik’s Internal Medicine – Textbook of Internal Diseases.
Available at: https://www.mp.pl/interna/chapter/B16.II.6.2.1 (accessed December 6, 2025).
15. Pizza F, D'Antonio D, Lucido FS, Tolone S, Del Genio G, Dell'Isola C, Docimo L, Gambardella C.
The role of ursodeoxycholic acid (UDCA) in cholelithiasis management after one anastomosis gastric bypass for morbid obesity: results of a monocentric randomized controlled trial.
Obes Surg. 2020;30(11):4315–4324. https://doi.org/10.1007/s11695-020-04801-z
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Copyright (c) 2026 Martyna Grześkowiak, Julita Jagodzińska , Agata Juchniewicz, Jakub Sapikowski, Maria Janiszewska, Iga Kuba, Jakub Idziński, Anna Lubomska, Igor Jętasiewicz, Mikołaj Góralczyk
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