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. 1983 Jan;24(1):11–15. doi: 10.1136/gut.24.1.11

Chemical and physical properties of gall stones in South Australia: implications for dissolution treatment.

M J Whiting, B M Bradley, J M Watts
PMCID: PMC1419919  PMID: 6848428

Abstract

Of 406 consecutive patients with gall-bladder stones, 387 were treated by cholecystectomy and 19 were treated with chenodeoxycholic acid. The gall stones found in 356 of the 387 patients at operation were analysed chemically for cholesterol and calcium, physically for number, size, and mass, and radiologically before cholecystectomy for stone lucency. Gall stones rich in cholesterol (greater than 80% by weight) were present in 75% of patients, while pigment stones (less than 25% cholesterol) were found in 12% of patients. Out of the 406 gall-stone patients, 77 (19%) had functioning gall bladders which contained radiolucent stones 1.5 cm or less in diameter, thereby fulfilling the criteria which are used by most clinicians in selecting patients for dissolution therapy of cholesterol gall stones. The stones of 61 of these patients were available for chemical analysis and 52 (85%) were rich in cholesterol. Using the more stringent criterion for stone size of 1 cm or less in diameter, only 11% of patients had stones suitable for dissolution treatment. Taking into account other factors such as lack of compliance with treatment, obesity, and calcium salts in gall stones, it appears that no more than 10% of gall-stone patients presenting to a general hospital could be successfully treated with chenodeoxycholic acid.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Bennion L. J., Grundy S. M. Risk factors for the development of cholelithiasis in man (second of two parts). N Engl J Med. 1978 Nov 30;299(22):1221–1227. doi: 10.1056/NEJM197811302992205. [DOI] [PubMed] [Google Scholar]
  3. Dowling R. H. Chenodeoxycholic acid therapy of gallstones. Clin Gastroenterol. 1977 Jan;6(1):141–163. [PubMed] [Google Scholar]
  4. Iser J. H., Maton P. N., Murphy G. M., Dowling R. H. Resistance to chenodeoxycholic acid (CDCA) treatment in obese patients with gall stones. Br Med J. 1978 Jun 10;1(6126):1509–1512. doi: 10.1136/bmj.1.6126.1509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Schoenfield L. J., Lachin J. M. Chenodiol (chenodeoxycholic acid) for dissolution of gallstones: the National Cooperative Gallstone Study. A controlled trial of efficacy and safety. Ann Intern Med. 1981 Sep;95(3):257–282. doi: 10.7326/0003-4819-95-3-257. [DOI] [PubMed] [Google Scholar]
  6. Shaffer E. A. Gallstones: current concepts of pathogenesis and medical dissolution. Can J Surg. 1980 Nov;23(6):517-32, 557. [PubMed] [Google Scholar]
  7. Soloway R. D., Trotman B. W., Ostrow J. D. Pigment gallstones. Gastroenterology. 1977 Jan;72(1):167–182. [PubMed] [Google Scholar]
  8. Sutor D. J., Wooley S. E. A statistical survey of the composition of gallstones in eight countries. Gut. 1971 Jan;12(1):55–64. doi: 10.1136/gut.12.1.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Trotman B. W., Soloway R. D. Pigment vs cholesterol cholelithiasis: clinical and epidemiological aspects. Am J Dig Dis. 1975 Aug;20(8):735–740. doi: 10.1007/BF01070831. [DOI] [PubMed] [Google Scholar]
  10. Whiting M. J., Jarvinen V., Watts J. M. Chemical composition of gallstones resistant to dissolution therapy with chenodeoxycholic acid. Gut. 1980 Dec;21(12):1077–1081. doi: 10.1136/gut.21.12.1077. [DOI] [PMC free article] [PubMed] [Google Scholar]

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