Gall Stones - Do you use Actigall (Ursodiol)?

Yikes - glad you are ok. Hopefully I will not have problems. Thanks!

I believe Actigall is to prevent gallstones, but not to treat them. I would press why he refuses to remove the gallbladder, given the large number of people who wind up getting it removed within a couple of years, anyway, unless he's holding out for another payout.

My doc took mine out (and appendix) just as a precaution. She did order an ultrasound to see if there was any stones, and I only had sludge. I suspect it was a determining factor of whether or not she could bill for that part of the procedure.

If you have stones already, though, I would see that as reason enough to get it out. If he refuses, perhaps another consult would be in order. You can get the VSG at many practices.

I will talk with him again, I have stones and I do not want to go back for surgery later or have an attack. That is nice she took yours out and your appendix! Thanks!

Many bariatric practices place patients on Actigall (300 mg twice daily for at least 6 months) after both gastric bypass and sleeve gastrectomy. The increased risk factor is due to rapid weight loss after bariatric surgery and change in the gallbladder function which is secondary to surgery. Many observational studies support this fact, and a high incidence of 28% -71% after gastric bypass surgery (RYGB) was reported in them. According to another publication, the incidence of gallbladder diseases is 5-36% after VSG and 2.8-36% after gastric bypass surgery.

A randomized prospective trial showed that 300 mg twice daily reduced the risks of stone formation after gastric bypass from about 30% to 2%.

For some, the use of Actigall is somewhat controversial. While about 30% of patients may develop gallstones after GBP if left untreated, only about 9% develop sypmptomatic gallstones. If there are existing gallstones, it seems prudent to err on the side of caution -- and take the Actigall for the six months -- if the surgeon refuses to remove it at the time of surgery. I would seriously question why he refuses to remove an already problematic gallbladder, however.

That said, I had no gallbladder issues before surgery and also took Actigall for the 6 month period afterwards. I had no issues or problems from the medications nor with my gallbladder.

Sources:

A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss.

CONCLUSION: A daily dose of 600 mg ursodiol is effective prophylaxis for gallstone formation following GBP-induced rapid weight loss.

Expectant management of the asymptomatic gallbladder at Roux-en-Y gastric bypass

Thank you Kat - I am going to call tomorrow and ask for the RX. I am going to ask again about removing the gall bladder, I have not had any problems, but I have stones. So....I think it is a matter of time until I have an attack. Thanks again!