الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
S
UMMARY
verweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 kg/m2 is considered overweight, and over 30 kg/m2 is obese.
The issue has grown to epidemic proportions, with over 4 million people dying each year as a result of being overweight or obese in 2017 according to the global burden of disease.
Obesity is one side of the double burden of malnutrition, and today more people are obese than underweight in every region except sub- Saharan Africa and Asia. Once considered a problem only in high-income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.
In this context, bariatric surgery continues to be the main therapeutic mode for a high rate of sustainable weight loss. However, morbid obesity, along with bariatric surgery and the subsequent weight loss, is associated with an increased risk for the development of gallstones and the risk is higher during a period of acute weight loss.
Ursodeoxycholic acid (UDCA) is a secondary bile acid that was associated with prevention of gallstone formation in obese patients undergoing acute weight loss. During weight loss, it is believed to decrease bile lithogenicity.
O
Summary
95
In fact, UDCA reduces the intestinal absorption and biliary secretion of cholesterol. The main advantages regarding administration of UDCA are its short-term duration and safety.
Currently, there is no consensus regarding gallstone prevention in obese patients undergoing bariatric procedures. Prophylactic cholecystectomy has been proposed as a preventive strategy given that it has not been associated with increased morbidity or mortality.
Even though concomitant cholecystectomy at laparoscopic RYGB is much more challenging, it has been proven feasible and safe, especially in cases of ultrasonography-confirmed gallbladder pathology. In contrast, cholecystectomy performed after RYGB has been associated with increased incidence of adverse events.
However, the cost-effectiveness of this option remains debatable.
Consequently, UDCA remains an attractive alternative during rapid weight loss.
Consequently, this study was conducted and aimed to assess the efficacy of ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery.
In conclusion, if no contraindications, ursodeoxycholic acid is advised to be used in prevention of postoperative symptomatic gallstone disease in obese patients undergoing bariatric surgery.
Summary
96
The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes, obesity grading and dietary follow up for reassessment of our study outcomes and confirmation of our conclusion.