Abstract
The gallstones of 14 patients, who had been treated unsuccessfully with chenodeoxycholic acid (15 mg/kg/day) for at lest six months, were obtained at cholecystectomy. The stones were then analysed for their cholesterol and calcium content. Two patients' stones were black in colour and low in cholesterol content, and were classified as pigment stones. Of the remaining 12 patients' stones, which all contained more than 70% cholesterol, 10 contained at lest 1% calcium on the stone surface. In two patients, the surface contained sufficient calcium to form a radio-opaque layer, although the stones had been radiolucent at the start of dissolution therapy. Overall, the results suggest that deposition of calcium salts inhibits the dissolution treatment of gallstones with chenodeoxycholic acid, irrespective of the radiolucency of the stones.
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Selected References
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- BARTLETT G. R. Phosphorus assay in column chromatography. J Biol Chem. 1959 Mar;234(3):466–468. [PubMed] [Google Scholar]
- Barbara L., Roda E., Roda A., Sama C., Festi D., Mazzella G., Aldini R. The medical treatment of cholesterol gallstones: experience with chenodeoxycholic acid. Digestion. 1976;14(3):209–219. doi: 10.1159/000197933. [DOI] [PubMed] [Google Scholar]
- Beker S. Treatment of cholesterol gallstones with chenic acid. A follow-up study of 25 patients. Am J Gastroenterol. 1977 Nov;68(5):456–460. [PubMed] [Google Scholar]
- Bell G. D., Dowling R. H., Whitney B., Sutor D. J. The value of radiology in predicting gallstone type when selecting patients for medical treatment. Gut. 1975 May;16(5):359–364. doi: 10.1136/gut.16.5.359. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bell G. D., Sutor D. J., Whitney B., Dowling R. Factors influencing human gallstone dissolution in monkey, dog, and human bile. Gut. 1972 Oct;13(10):836–836. [PubMed] [Google Scholar]
- Dowling R. H. Chenodeoxycholic acid therapy of gallstones. Clin Gastroenterol. 1977 Jan;6(1):141–163. [PubMed] [Google Scholar]
- FOLCH J., LEES M., SLOANE STANLEY G. H. A simple method for the isolation and purification of total lipides from animal tissues. J Biol Chem. 1957 May;226(1):497–509. [PubMed] [Google Scholar]
- Holzbach R. T., Marsh M., Olszewski M., Holan K. Cholesterol solubility in bile. Evidence that supersaturated bile is frequent in healthy man. J Clin Invest. 1973 Jun;52(6):1467–1479. doi: 10.1172/JCI107321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iser J. H., Dowling H., Mok H. Y., Bell G. D. Chenodeoxycholic acid treatment of gallstones. A follow-up report and analysis of factors influencing response to therapy. N Engl J Med. 1975 Aug 21;293(8):378–383. doi: 10.1056/NEJM197508212930804. [DOI] [PubMed] [Google Scholar]
- Shaffer E. A., Small D. M. Biliary lipid secretion in cholesterol gallstone disease. The effect of cholecystectomy and obesity. J Clin Invest. 1977 May;59(5):828–840. doi: 10.1172/JCI108705. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soloway R. D., Trotman B. W., Ostrow J. D. Pigment gallstones. Gastroenterology. 1977 Jan;72(1):167–182. [PubMed] [Google Scholar]
- Sutor D. J., Wilkie L. I. Calcium carbonate in human gallstones and total CO2 in bile. Gut. 1978 Mar;19(3):220–224. doi: 10.1136/gut.19.3.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sutor D. J., Wilkie L. I. Calcium in bile and calcium salts in gallstones. Clin Chim Acta. 1977 Aug 15;79(1):119–127. doi: 10.1016/0009-8981(77)90469-7. [DOI] [PubMed] [Google Scholar]
- Thistle J. L., Hofmann A. F. Efficacy and specificity of chenodeoxycholic acid therapy for dissolving gallstones. N Engl J Med. 1973 Sep 27;289(13):655–659. doi: 10.1056/NEJM197309272891303. [DOI] [PubMed] [Google Scholar]
- Thistle J. L., Hofmann A. F., Ott B. J., Stephens D. H. Chenotherapy for gallstone dissolution. I. Efficacy and safety. JAMA. 1978 Mar 13;239(11):1041–1046. [PubMed] [Google Scholar]
- Thomas P. J., Hofmann A. F. Letter: A simple calculation of the lithogenic index of bile: expressing biliary lipid composition on rectangular coordinates. Gastroenterology. 1973 Oct;65(4):698–700. [PubMed] [Google Scholar]
- Trotman B. W., Petrella E. J., Soloway R. D., Sanchez H. M., Morris T. A., 3rd, Miller W. T. Evaluation of radiographic lucency or opaqueness of gallstones as a means of identifying cholesterol or pigment stones. Correlation of lucency or opaqueness with calcium and mineral. Gastroenterology. 1975 Jun;68(6):1563–1566. [PubMed] [Google Scholar]
- Whiting M. J., Watts J. M. Prediction of the bile acid composition of bile from serum bile acid analysis during gallstone dissolution therapy. Gastroenterology. 1980 Feb;78(2):220–225. [PubMed] [Google Scholar]
- Wolpers C. Auswahl der Gallensteinträger zur Litholyse. Leber Magen Darm. 1976;6(1):43–46. [PubMed] [Google Scholar]