Haal S, Guman MSS, Boerlage TCC, et al. - Ursodeoxycholic acid prophylaxis failed to confer a significant reduction in the occurrence of symptomatic gallstone disease in all patients after bariatric surgery.

• A multicenter, double-blind, randomized, placebo-controlled superiority trial of patients with an intact gallbladder scheduled for laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy.

• They were randomized to receive either ursodeoxycholic acid or placebo.

• Post-bariatric surgery, symptomatic gallstone disease occurred in 6·5% and in 9·7% patients in the ursodeoxycholic acid and placebo groups, respectively (relative risk 0·67).

• Ursodeoxycholic acid showed an effect in patients without asymptomatic gallstones at baseline.

• Decrease in the occurrence of symptomatic gallstone disease was achieved with ursodeoxycholic acid treatment, vs placebo, in patients without gallstones prior to RYGB surgery.

• Diarrhea occurred in 0·9% vs 0·4% and skin rash in 0·5% vs 0·4% patients in the ursodeoxycholic acid group vs placebo group, respectively.

• Ursodeoxycholic acid did not result in any serious adverse event.