Abstract
One hundred patients with radiolucent gall stones less than or equal to 1.5 cm in functioning gall bladders have received oral bile acid dissolution therapy since 1975. Complete data are available on 93 who have received at least six months' treatment. The complete dissolution rate in appropriately selected patients who complied with and tolerated an adequate course of treatment was 55%. By life table analysis the recurrence rates were 13% at one year, 21% at two years, 31% at three years, and 43% at four years. Thereafter the recurrence rate levelled out, being 49% at 11 years. Redissolution was achieved in all seven patients who had a second course of therapy, but was usually followed by re-recurrence. Patients whose gall stones recurred did not differ significantly from those who remained stone free with respect to age, sex, body weight, or time required for dissolution.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bachrach W. H., Hofmann A. F. Ursodeoxycholic acid in the treatment of cholesterol cholelithiasis. part I. Dig Dis Sci. 1982 Aug;27(8):737–761. doi: 10.1007/BF01393771. [DOI] [PubMed] [Google Scholar]
- Bell G. D., Whitney B., Dowling R. H. Gallstone dissolution in man using chenodeoxycholic acid. Lancet. 1972 Dec 9;2(7789):1213–1216. doi: 10.1016/s0140-6736(72)92266-0. [DOI] [PubMed] [Google Scholar]
- Burnstein M. J., Ilson R. G., Petrunka C. N., Taylor R. D., Strasberg S. M. Evidence for a potent nucleating factor in the gallbladder bile of patients with cholesterol gallstones. Gastroenterology. 1983 Oct;85(4):801–807. [PubMed] [Google Scholar]
- Danzinger R. G., Hofmann A. F., Schoenfield L. J., Thistle J. L. Dissolution of cholesterol gallstones by chenodeoxycholic acid. N Engl J Med. 1972 Jan 6;286(1):1–8. doi: 10.1056/NEJM197201062860101. [DOI] [PubMed] [Google Scholar]
- Forgacs I. C., Maisey M. N., Murphy G. M., Dowling R. H. Influence of gallstones and ursodeoxycholic acid therapy on gallbladder emptying. Gastroenterology. 1984 Aug;87(2):299–307. [PubMed] [Google Scholar]
- Gleeson D., Ruppin D. C. Discrepancies between cholecystography and ultrasonography in the detection of recurrent gallstones. J Hepatol. 1985;1(6):597–607. doi: 10.1016/s0168-8278(85)80003-9. [DOI] [PubMed] [Google Scholar]
- Holan K. R., Holzbach R. T., Hermann R. E., Cooperman A. M., Claffey W. J. Nucleation time: a key factor in the pathogenesis of cholesterol gallstone disease. Gastroenterology. 1979 Oct;77(4 Pt 1):611–617. [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]
- Iser J. H., Murphy G. M., Dowling R. H. Speed of change in biliary lipids and bile acids with chenodeoxycholic acid--is intermittent therapy feasible? Gut. 1977 Jan;18(1):7–15. doi: 10.1136/gut.18.1.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lanzini A., Jazrawi R. P., Kupfer R. M., Maudgal D. P., Joseph A. E., Northfield T. C. Gallstone recurrence after medical dissolution. An overestimated threat? J Hepatol. 1986;3(2):241–246. doi: 10.1016/s0168-8278(86)80033-2. [DOI] [PubMed] [Google Scholar]
- Maton P. N., Iser J. H., Reuben A., Saxton H. M., Murphy G. M., Dowling R. H. Outcome of chenodeoxycholic acid (CDCA) treatment in 125 patients with radiolucent gallstones. Factors influencing efficacy, withdrawal, symptoms and side effects and post-dissolution recurrence. Medicine (Baltimore) 1982 Mar;61(2):86–97. doi: 10.1097/00005792-198203000-00003. [DOI] [PubMed] [Google Scholar]
- Mok H. Y., Bell G. D., Dowling R. H. Effect of different doses of chenodeoxycholic acid on bile-lipid composition and on frequency of side-effects in patients with gallstones. Lancet. 1974 Aug 3;2(7875):253–257. doi: 10.1016/s0140-6736(74)91415-9. [DOI] [PubMed] [Google Scholar]
- Pomeranz I. S., Shaffer E. A. Abnormal gallbladder emptying in a subgroup of patients with gallstones. Gastroenterology. 1985 Mar;88(3):787–791. doi: 10.1016/0016-5085(85)90152-0. [DOI] [PubMed] [Google Scholar]
- Ruppin D. C., Dowling R. H. Is recurrence inevitable after gallstone dissolution by bile-acid treatment? Lancet. 1982 Jan 23;1(8265):181–185. doi: 10.1016/s0140-6736(82)90757-7. [DOI] [PubMed] [Google Scholar]
- Ruppin D. C., Murphy G. M., Dowling R. H. Gall stone disease without gall stones--bile acid and bile lipid metabolism after complete gall stone dissolution. Gut. 1986 May;27(5):559–566. doi: 10.1136/gut.27.5.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Sutor D. J., Percival J. M. Presence or absence of inhibitors of crystal growth in bile. 1. Effect of bile on the formation of calcium phosphate, a constituent of gallstones. Gut. 1976 Jul;17(7):506–510. doi: 10.1136/gut.17.7.506. [DOI] [PMC free article] [PubMed] [Google Scholar]