Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis

Autor: Ngozi I. Okoro, Amil Patel, Qiang Cai, Marney Goldstein, Naveen Narahari
Rok vydání: 2007
Předmět:
Adult
Male
Abdominal pain
medicine.medical_specialty
medicine.drug_class
medicine.medical_treatment
Lithiasis
Gastroenterology
Risk Assessment
Severity of Illness Index
Drug Administration Schedule
Statistics
Nonparametric
law.invention
Randomized controlled trial
law
Reference Values
Internal medicine
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Pain Measurement
Probability
Cholangiopancreatography
Endoscopic Retrograde
Pain
Postoperative
Bile acid
Dose-Response Relationship
Drug
business.industry
Gallbladder
Therapeutic effect
Ursodeoxycholic Acid
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Ursodeoxycholic acid
medicine.anatomical_structure
Choledocholithiasis
Treatment Outcome
Cholecystectomy
Laparoscopic
Sphincter of Oddi dysfunction
Cholecystectomy
Female
medicine.symptom
business
medicine.drug
Follow-Up Studies
Zdroj: Gastrointestinal endoscopy. 68(1)
ISSN: 1097-6779
Popis: Background Microlithiasis has been identified as a cause of idiopathic acute pancreatitis in patients with an intact gallbladder. Microlithiasis has also been identified in the bile of some patients who have undergone cholecystectomy. However, it is unknown whether bile microlithiasis causes postcholecystectomy pain. Objective To identify bile microlithiasis in patients with postcholecystectomy pain and to investigate the therapeutic effect of ursodeoxycholic acid (urso) on such patients with microlithiasis in the bile. Design Prospective randomized trial. Setting Tertiary medical center. Patients Patients with postcholecystectomy pain and bile crystals. Interventions Urso treatment. Main Outcome Measurements The severity and frequency of right upper-quadrant abdominal pain were compared with and without urso treatment, and before and after urso treatment. Results A total of 118 patients with postcholecystectomy pain were screened for the study. Twelve patients (10%) were identified with bile crystals. In the first phase, 6 of these patients received urso treatment, whereas the other 6 patients did not receive urso treatment. In the second phase, the latter 6 patients were given the urso treatment. After using urso for a few months, their biliary-type abdominal pain significantly improved or resolved. In the control group, there was no improvement in symptoms. There was a significant difference between the 2 groups ( P = .01). Limitations Single-center, small number of patients. Conclusions This study provided evidence that supports the hypothesis that bile microlithiasis is indeed a cause for postcholecystectomy pain. Patients with such postcholecystectomy pain may benefit from a microscopic examination of bile for crystals or microlithiasis, and urso treatment if bile crystals are identified.
Databáze: OpenAIRE
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