Ryuichi Yamamoto1, Susumu Tazuma2, Keishi Kanno1, Yoshinori Igarashi3, Kazuo Inui4, Hirotaka Ohara5, Toshio Tsuyuguchi6, Shomei Ryozawa7. 1. Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. 2. Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. stazuma@hiroshima-u.ac.jp. 3. Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan. 4. Department of Internal Medicine, Banbuntane Houtokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan. 5. Department of Community-Based Medical Educations, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 6. Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. 7. Saitama Medical University International Medical Center, Saitama, Japan.
Abstract
BACKGROUND: Currently, no established pharmacologic treatment exists for the prevention of recurrent common bile duct (CBD) stones. METHODS: Here, we present a multi-center randomized trial that compared the CBD recurrence rate after bile duct stone removal between patients given ursodeoxycholic acid (UDCA) and the untreated group. A total of 36 patients were randomly assigned to either the UDCA (n = 15) or the untreated group (n = 21). The primary end-point was the recurrence rate of CBD stones. RESULTS: The recurrence rate of CBD stones was 6.6% in the UDCA group and 18.6% in the untreated group (P = 0.171). A multivariate analysis found that not receiving UDCA was an independent risk factor for stone recurrence. The recurrence rates of CBD stones did not differ by sex, past history of cholecystectomy, or the presence of gallstones. CONCLUSIONS: Our findings indicate that UDCA may be a novel treatment strategy to prevent the recurrence of CBD stones. However, further evaluation of UDCA in a larger number of subjects will be required to confirm the applicability of these results.
RCT Entities:
BACKGROUND: Currently, no established pharmacologic treatment exists for the prevention of recurrent common bile duct (CBD) stones. METHODS: Here, we present a multi-center randomized trial that compared the CBD recurrence rate after bile duct stone removal between patients given ursodeoxycholic acid (UDCA) and the untreated group. A total of 36 patients were randomly assigned to either the UDCA (n = 15) or the untreated group (n = 21). The primary end-point was the recurrence rate of CBD stones. RESULTS: The recurrence rate of CBD stones was 6.6% in the UDCA group and 18.6% in the untreated group (P = 0.171). A multivariate analysis found that not receiving UDCA was an independent risk factor for stone recurrence. The recurrence rates of CBD stones did not differ by sex, past history of cholecystectomy, or the presence of gallstones. CONCLUSIONS: Our findings indicate that UDCA may be a novel treatment strategy to prevent the recurrence of CBD stones. However, further evaluation of UDCA in a larger number of subjects will be required to confirm the applicability of these results.
Authors: Quang Trung Tran; Van Huy Tran; Matthias Sendler; Julia Doller; Mats Wiese; Robert Bolsmann; Anika Wilden; Juliane Glaubitz; Jana Marielle Modenbach; Franziska Gisela Thiel; Laura L de Freitas Chama; Frank Ulrich Weiss; Markus M Lerch; Ali A Aghdassi Journal: Pancreas Date: 2021-01-01 Impact factor: 3.243