Meta-analysisindependent cross-checkabstract only checked I-BAR-12 standard review
Preventing gallstones after weight-loss surgery
Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials.
Overview
Mulliri A et al.. J Gastroenterol 2022 · PMID 35704084 · DOI 10.1007/s00535-022-01886-4
A bile-acid drug cut new gallstones by about 75% after surgery, including sleeve.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Gallstone prevention
- How was the study done?
Meta-analysis of RCTs
- How many people, animals or samples were studied?
3474
- What was actually found?
UDCA effective
- How large was the observed effect?
OR 0.25
- What do the results mean in everyday life?
Gallstones after surgery are expected and preventable
- What are the study's limitations?
Incidence not in abstract
- What does it say about Elawady's specific claim?
Supports that sleeve can lead to gallstones
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Absolute risk
Scientific in-depth review
1. Full reference
- Authors
- Mulliri A et al.
- Journal
- J Gastroenterol
- Year
- 2022
- Identifier
- PMID 35704084 DOI 10.1007/s00535-022-01886-4
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Does UDCA prevent gallstones after bariatric surgery?
3. Study design and population
- Study design
- Meta-analysis – Meta-analysis of 11 RCTs
- Population
Bariatric patients
- Sample size
2217 UDCA vs 1257 control analysed
4. Methods and endpoints
- Exposure / intervention
UDCA
- Comparator
No UDCA/placebo
- Endpoints
Gallstone formation, symptomatic gallstone disease, cholecystectomy
5. Actual results
- Results
UDCA reduced gallstone formation OR 0.25 (0.21-0.31), symptomatic gallstone disease OR 0.29 (0.20-0.42), cholecystectomy OR 0.33 (0.20-0.55); similar in sleeve subgroup.
- Absolute risks
Control-arm incidence not reported in abstract
- Authors' conclusion
UDCA prevents gallstone formation and symptomatic disease after bariatric surgery.
6. Strengths
- RCTs only
7. Weaknesses
- Control incidence not in abstract
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
Indirect support for C-BAR-13: gallstone formation after bariatric surgery (including sleeve) is frequent enough that 11 RCTs tested prevention.
11. Independent contrary findings
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Supports that gallstones after surgery are a recognized, preventable problem.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | indirect |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Sleeve gastrectomy causes gallstones (stones form faster after sleeve/rapid weight loss). – Studies supporting the claim