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. 1982 May 1;284(6325):1295–1297. doi: 10.1136/bmj.284.6325.1295

Gall-stone dissolution and recurrence: are we being misled?

K W Somerville, D H Rose, G D Bell, W R Ellis, D R Knapp
PMCID: PMC1498166  PMID: 6803946

Abstract

Oral cholecystography repeated at six-months intervals is the standard method for determining reduction in size of gall stones (partial success) and complete dissolution of stones (complete success). In a comparative study of oral cholecystography and cholecystosonography six out of 14 patients with gall stones achieving complete success by oral cholecystographic criteria had stones still detectable by ultrasonography. Repeat oral cholecystography in a further 11 patients receiving post-dissolution maintenance treatment detected stones in two, whereas ultrasonography detected stones in seven. In future complete dissolution of gall stones should be reported only if both oral cholecystography and ultrasonographic studies give negative results and the progress of patients receiving post-dissolution maintenance treatment is monitored by ultrasonography rather than serial oral cholecystography.

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Selected References

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

  1. Anderson J. C., Harned R. K. Gray scale ultrasonography of the gallbladder: an evaluation of accuracy and report of additional ultrasound signs. AJR Am J Roentgenol. 1977 Dec;129(6):975–977. doi: 10.2214/ajr.129.6.975. [DOI] [PubMed] [Google Scholar]
  2. Bartrum R. J., Jr, Crow H. C., Foote S. R. Ultrasonic and radiographic cholecystography. N Engl J Med. 1977 Mar 10;296(10):538–541. doi: 10.1056/NEJM197703102961004. [DOI] [PubMed] [Google Scholar]
  3. Bateson M. C., Bouchier I. A., Trash D. B., Maudgal D. P., Northfield T. C. Calcification of radiolucent gall stone during treatment with ursodeoxycholic acid. Br Med J (Clin Res Ed) 1981 Sep 5;283(6292):645–646. doi: 10.1136/bmj.283.6292.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bell G. D., Doran J. Gall stone dissolution in man using an essential oil preparation. Br Med J. 1979 Jan 6;1(6155):24–24. doi: 10.1136/bmj.1.6155.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bell G. D. The present position concerning gallstone dissolution. Gut. 1974 Nov;15(11):913–929. doi: 10.1136/gut.15.11.913. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. 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]
  7. Cooperberg P. L., Pon M. S., Wong P., Stoller J. L., Burhenne H. J. Real-time high resolution ultrasound in the detection of biliary calculi. Radiology. 1979 Jun;131(3):789–790. doi: 10.1148/131.3.789. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Ellis W. R., Bell G. D., Middleton B., White D. A. Adjunct to bile-acid treatment for gall-stone dissolution: low-dose chenodeoxycholic acid combined with a terpene preparation. Br Med J (Clin Res Ed) 1981 Feb 21;282(6264):611–612. doi: 10.1136/bmj.282.6264.611-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Nakagawa S., Makino I., Ishizaki T., Dohi I. Dissolution of cholesterol gallstones by ursodeoxycholic acid. Lancet. 1977 Aug 20;2(8034):367–369. doi: 10.1016/s0140-6736(77)90301-4. [DOI] [PubMed] [Google Scholar]
  11. Polli E. E., Bianchi P. A., Conte D., Sironi L. Treatment of radiolucent gallstones with CDCA or UDCA. A multicenter trial. Digestion. 1981;22(4):185–191. doi: 10.1159/000198643. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. 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]
  14. Simeone J. F., Ferrucci J. T., Jr New trends in gallbladder imaging. JAMA. 1981 Jul 24;246(4):380–383. [PubMed] [Google Scholar]
  15. 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]

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