Effect of Rowachol and ursodeoxycholic acid in the prevention of postcholecystectomy pain after laparoscopic cholecystectomy

Background: Patients often experience various symptoms from the immediate postoperative period to even years after. Rowachol is a terpene mixture that enhances the solubility of cholesterol, calcium carbonate, and calcium phosphate, which makes it a potent choleretic agent. Ursodeoxycholic acid can improve gallbladder contractility by decreasing cholesterol content in the plasma membrane of muscle cells and can stimulate biliary secretion, leading to relieved cholestasis. Aim: To determine whether Rowachol and ursodeoxycholic acid were useful in the prevention of postcholecystectomy pain. Patients and Methods: This randomized, clinical trial included 225 patients who underwent laparoscopic cholecystectomy and were randomly distributed into three groups according to the type of interventions. Group A included 75 patients who received Rowachol at a dose of 100 mg three times daily for 3 months; group B included 75 patients who received ursodeoxycholic acid at a dose of 300 mg twice daily for 3 months, and the control group included 75 patients who did not receive any. Technical difficulties were assessed also using the Parkland grading scale, which assesses the initial view of the gallbladder. Postoperatively, the patients were assessed by biliary pain score. Results: A higher percentage of patients in groups A and B had a Parkland score of more than II (21.3; 16%) compared to the control group. There were no statistically significant differences between the studied groups as regards postoperative complication incidence or postoperative pain grade. Mean Parkland grading was higher among intervention groups than the control group with a statistically significant difference. A higher percentage of patients in intervention groups experienced grades III and IV postoperative pain than the control group with a statistically significant difference. Mean values for postoperative pain grade were higher among the intervention group than the control group with a statistically significant difference. Conclusion: In conclusion, both Rowachol and ursodeoxycholic acid did not have a significant effect on postlaparoscopic cholecystectomy pain incidence