The Use of Simvastatin for the Prevention of Gallstones in the Lithogenic Prairie Dog Model |
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Authors: | Kurt G Davis Thomas M Wertin John P Schriver |
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Institution: | (1) Department of General Surgery, William Beaumont Army Medical Center, El Paso, TX, USA;(2) Department of General Surgery, William Beaumont Army Medical Center, El Paso, TX, USA;(3) Department of General Surgery, William Beaumont Army Medical Center, El Paso, TX, USA |
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Abstract: | Background: Surgery for morbid obesity is rapidly increasing. Patients undergoing bariatric surgery are prone to gallstone
development during the rapid weight loss. These patients are often given medications such as ursodeoxycholic acid to prevent
gallstone formation; however, these medications are often poorly tolerated by patients, who subsequently discontinue them.
We performed a study in a lithogenic animal model to assess the effectiveness of a potential alternate medication for gallstone
prevention. Methods: 20 male prairie dogs were randomly separated into 2 groups and fed a lithogenic diet for 28 days. The
study group animals were given 2.5 mg of the HMG-CoA reductase inhibitor simvastatin. Total cholesterol and triglycerides
were measured and an open cholecystectomy was performed on each animal at the conclusion of the study period. The gallbladder
was visually inspected for gallstones and microscopic biliary cholesterol crystal formation. Results: There was a decrease
of 36% in the total cholesterol of the study animals compared to controls. The animals treated with simvastatin showed gallstone
formation in 5/10 (50%) of animals, compared with 6/10 (60%) of control animals. The study animals demonstrated microscopic
cholesterol crystal formation in 80%, identical to the number found in the control animals. Conclusion: Despite a reduction
in cholesterol, simvastatin prevented neither gallstone formation nor biliary cholesterol crystals in this animal model. Given
the rapid increase in the number of bariatric surgical procedures coupled with the poor tolerance of ursodeoxycholic acid,
viable alternatives should continue to be sought for these patients. |
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Keywords: | LITHOGENIC DIET SIMVASTATIN CHOLELITHIASIS PRAIRIE DOG MORBID OBESITY |
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