{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T02:51:04Z","timestamp":1776307864741,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","award":["848015003"],"award-info":[{"award-number":["848015003"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Zambon Netherlands"},{"name":"Foundation for Clinical Research of the Slotervaart Hospital"},{"name":"Spaarne Gasthuis Academy"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The aim was to evaluate the cost-effectiveness and cost\u2013utility of ursodeoxycholic acid (UDCA) prophylaxis for the prevention of symptomatic gallstone disease after Roux-en-Y gastric bypass (RYGB) in patients without gallstones before surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from a multicentre, double-blind, randomized placebo-controlled superiority trial were used. Patients scheduled for laparoscopic RYGB or sleeve gastrectomy were randomized to receive 900\u2005mg UDCA or placebo for 6 months. Indicated by the clinical report, prophylactic prescription of UDCA was evaluated economically against placebo from a healthcare and societal perspective for the subgroup of patients without gallstones before surgery who underwent RYGB. Volumes and costs of in-hospital care, out-of-hospital care, out-of-pocket expenses, and productivity loss were assessed. Main outcomes were the costs per patient free from symptomatic gallstone disease and the costs per quality-adjusted life-year (QALY).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients receiving UDCA prophylaxis were more likely to remain free from symptomatic gallstone disease (relative risk 1.06, 95 per cent c.i. 1.02 to 1.11; P = 0.002) compared with patients in the placebo group. The gain in QALYs, corrected for a baseline difference in health utility, was 0.047 (95 per cent bias-corrected and accelerated (Bca) c.i. 0.007 to 0.088) higher (P = 0.022). Differences in costs were \u2013\u20ac356 (95 per cent Bca c.i. \u20ac\u20131573 to 761) from a healthcare perspective and \u2013\u20ac1392 (\u20133807 to 917) from a societal perspective including out-of-pocket expenses and productivity loss, both statistically non-significant, in favour of UDCA prophylaxis. The probability of UDCA prophylaxis being cost-effective was at least 0.872.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>UDCA prophylaxis after RYGB in patients without gallstones before surgery was cost-effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znac273","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T11:10:15Z","timestamp":1664968215000},"page":"1116-1123","source":"Crossref","is-referenced-by-count":7,"title":["Cost-effectiveness of ursodeoxycholic acid in preventing new-onset symptomatic gallstone disease after Roux-en-Y gastric bypass surgery"],"prefix":"10.1093","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7668-9164","authenticated-orcid":false,"given":"Sylke","family":"Haal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis , Hoofddorp , the Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maimoena S S","family":"Guman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis , Hoofddorp , the Netherlands"},{"name":"Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, \u00a0 the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L Maurits","family":"de Brauw","sequence":"additional","affiliation":[{"name":"Department of Surgery, Spaarne Gasthuis , Hoofddorp , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben","family":"Schouten","sequence":"additional","affiliation":[{"name":"Department of Surgery, Flevohospital , Almere , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben N","family":"van Veen","sequence":"additional","affiliation":[{"name":"Department of Surgery, OLVG , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor E A","family":"Gerdes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis , Hoofddorp , the Netherlands"},{"name":"Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, \u00a0 the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-019X","authenticated-orcid":false,"given":"Rogier P","family":"Voermans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel G W","family":"Dijkgraaf","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Methodology , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"2023063011121460000_znac273-B1","doi-asserted-by":"crossref","first-page":"16024","DOI":"10.1038\/nrdp.2016.24","article-title":"Gallstones","volume":"2","author":"Lammert","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2023063011121460000_znac273-B2","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1007\/s11695-015-1858-5","article-title":"Randomized, prospective comparison of ursodeoxycholic acid for the prevention of gallstones after sleeve gastrectomy","volume":"26","author":"Adams","year":"2016","journal-title":"Obes Surg"},{"key":"2023063011121460000_znac273-B3","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.soard.2019.03.028","article-title":"Effect of oral ursodeoxycholic acid on cholelithiasis following laparoscopic sleeve gastrectomy for morbid obesity","volume":"15","author":"Nabil","year":"2019","journal-title":"Surg Obes Relat Dis"},{"key":"2023063011121460000_znac273-B4","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s13304-020-00850-2","article-title":"The use of Ursolit for gallstone prophylaxis following bariatric surgery: a randomized-controlled trial","volume":"72","author":"Sakran","year":"2020","journal-title":"Updates Surg"},{"key":"2023063011121460000_znac273-B5","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.soard.2018.03.028","article-title":"Incidence of cholecystectomy after bariatric surgery","volume":"14","author":"Altieri","year":"2018","journal-title":"Surg Obes Relat Dis"},{"key":"2023063011121460000_znac273-B6","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.soard.2016.11.022","article-title":"Evaluation of incidence of cholelithiasis after bariatric surgery in subjects treated or not treated with ursodeoxycholic acid","volume":"13","author":"Coupaye","year":"2017","journal-title":"Surg Obes Relat Dis"},{"key":"2023063011121460000_znac273-B7","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.soard.2007.02.006","article-title":"Expectant management of the asymptomatic gallbladder at Roux-en-Y gastric bypass","volume":"3","author":"Portenier","year":"2007","journal-title":"Surg Obes Relat Dis"},{"key":"2023063011121460000_znac273-B8","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1007\/s11695-017-2924-y","article-title":"Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: an updated systematic review and meta-analysis","volume":"27","author":"Magouliotis","year":"2017","journal-title":"Obes Surg"},{"key":"2023063011121460000_znac273-B9","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.cgh.2013.11.031","article-title":"Ursodeoxycholic acid and diets higher in fat prevent gallbladder stones during weight loss: a meta-analysis of randomized controlled trials","volume":"12","author":"Stokes","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2023063011121460000_znac273-B10","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/S2468-1253(21)00301-0","article-title":"Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial","volume":"6","author":"Haal","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2023063011121460000_znac273-B11","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s12876-017-0674-x","article-title":"Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery: study protocol for a randomized controlled trial (UPGRADE trial)","volume":"17","author":"Boerlage","year":"2017","journal-title":"BMC Gastroenterol"},{"key":"2023063011121460000_znac273-B12","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1186\/s13063-020-04605-7","article-title":"Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery: statistical analysis plan for a randomised controlled trial (UPGRADE trial)","volume":"21","author":"Haal","year":"2020","journal-title":"Trials"},{"key":"2023063011121460000_znac273-B13","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/S2468-1253(21)00383-6","article-title":"Bariatric surgery and prophylaxis against symptomatic gallstone disease","volume":"6","author":"Welbourn","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2023063011121460000_znac273-B14","doi-asserted-by":"crossref","first-page":"f1049","DOI":"10.1136\/bmj.f1049","article-title":"Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement","volume":"346","author":"Husereau","year":"2013","journal-title":"BMJ"},{"key":"2023063011121460000_znac273-B15","author":"Institute for Medical Technology Assessment"},{"key":"2023063011121460000_znac273-B16","author":"Hakkaart-van Roijen","year":"2015"},{"key":"2023063011121460000_znac273-B17","author":"Centraal Bureau voor Statistiek"},{"key":"2023063011121460000_znac273-B18","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jval.2016.01.003","article-title":"Dutch tariff for the five-level version of EQ-5D","volume":"19","author":"Versteegh","year":"2016","journal-title":"Value Health"},{"key":"2023063011121460000_znac273-B19","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.1002\/1097-0258(20001215)19:23<3219::AID-SIM623>3.0.CO;2-P","article-title":"Analysis of cost data in randomized trials: an application of the non-parametric bootstrap","volume":"19","author":"Barber","year":"2000","journal-title":"Stat Med"},{"key":"2023063011121460000_znac273-B20","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s11695-019-04166-y","article-title":"Risk factors for cholecystectomy after laparoscopic Roux-en-Y gastric bypass","volume":"30","author":"Haal","year":"2020","journal-title":"Obes Surg"},{"key":"2023063011121460000_znac273-B21","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1038\/sj.ijo.0800513","article-title":"Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction","volume":"21","author":"Shoheiber","year":"1997","journal-title":"Int J Obes Relat Metab Disord"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/109\/11\/1116\/50746609\/znac273.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/109\/11\/1116\/50746609\/znac273.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T11:12:34Z","timestamp":1688123554000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/109\/11\/1116\/6670957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,8,18]]},"published-print":{"date-parts":[[2022,10,14]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znac273","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,8,18]]}}}