Gilbert's Syndrome: Current Insights, Outcomes and Therapies
Long-term observation and recent advances in genetic diagnostic techniques that detect Gilbert's syndrome (GS) have confirmed that this syndrome is associated with biliary tract disorders, and in some cases even with cholelithiasis. Study Objective: To determine the prevalence and forms of biliary tract disorders in children with GS. The study also investigated the potential of ursodeoxycholic acid (UDCA, Ursosan) to prevent biliary tract disorders. Study design: This is a single-centre comparative retrospective (1992-2010) study. Materials: We evaluated data on 181 children with GS. These children were assigned to two groups: Group 1 received prophylactic treatment with UDCA (Ursosan); Group 2 did not receive this therapy. Results: Patients who had regular prophylactic UDCA treatment, showed a reduction in the rate of cholelithiasis (4.2-fold, 2.8% vs. 11.8%), biliary dyskinesia (2.2 fold, 32.4% vs. 76.4%), and biliary dyskinesia associated with sludge syndrome (2.2-fold; 21.5% vs. 47.6%, respectively). In the group receiving prophylactic UDCA treatment, 64.8% of children did not have any biliary tract disorders (compared to only 11.8% in the non-UDCA group). Conclusion: UDCA (Ursosan) should be used in patients with GS in order to prevent and treat biliary tract disorders (biliary dyskinesia, sludge syndrome, and cholelithiasis).