RSS Feeds
Prevention of Gallstones during Weight Reduction
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Shiffman and colleagues [1] have shown that ursodeoxycholic acid (UDCA) is effective in preventing gallstone formation in patients receiving a very-low-calorie diet. The reported incidence of gallstone formation in patients receiving placebo (28%) is similar to that noted in other reports [2]. However, most gallstones that form while patients are receiving a very-low-calorie diet are asymptomatic. The highest reported incidence of symptomatic gallstones causing cholecystitis is 6% [2], and the largest study that reported such data [3] showed only one case of symptomatic gallstones among 517 patients receiving a very-low-calorie diet and only one other case requiring a cholecystectomy in the year after treatment. Other series have reported an incidence of cholecystitis ranging from 0% to 3% [4]. In my experience with more than 75 patients receiving a very-low-calorie diet, I have seen no episodes of symptomatic gallstones. Asymptomatic gallstones that form while patients are receiving a very-low-calorie diet may spontaneously resolve [2].
Given the low incidence of symptomatic gallstones in patients receiving a very-low-calorie diet, giving UDCA to all patients would only add cost to an already expensive treatment. I doubt that the prophylactic use of UDCA in such patients will reduce the health care costs associated with the treatment of symptomatic gallstones.
Todd Kaye, MD
Lahey Clinic
Burlington, MA 01805
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
