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[Late results of cholelitholytic therapy of patients with cholelithiasis using chenodeoxycholic and ursodeoxycholic
Insights
Chenodeoxycholic and ursodeoxycholic acid treatments dissolved gallstones in some patients. Long-term follow-up showed no relapses in those who achieved stone clearance, suggesting a safe alternative for patients with cardiovascular issues.
Area of Science:
- Gastroenterology
- Hepatology
- Pharmacology
Background:
- Cholelithiasis (gallstones) affects a significant portion of the population.
- Surgical intervention for gallstones carries risks, especially for patients with comorbidities.
- Medical dissolution therapy offers a non-invasive treatment option.
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of chenodeoxycholic and ursodeoxycholic acid therapy for cholelithiasis.
- To assess the recurrence rate of gallstones after successful dissolution.
- To determine the suitability of this therapy for patients with concomitant cardiovascular disorders.
Main Methods:
- A cohort of 78 patients with cholelithiasis received chenodeoxycholic and ursodeoxycholic acids.
- Treatment duration averaged 12 months.
- Follow-up assessments were conducted to monitor stone clearance, recurrence, and clinical outcomes, including a 4.5-year observation period.
Main Results:
- Gallstones disappeared in 22 out of 78 patients (28.2%).
- Among those who achieved stone clearance, no relapses were observed over a 4.5-year follow-up period.
- Nine patients with recurrent cholelithiasis after therapy remained free of gallstone colic for 4.5 years.
Conclusions:
- Chenodeoxycholic and ursodeoxycholic acids are effective in dissolving gallstones in a subset of patients.
- Long-term remission is achievable after successful medical dissolution therapy.
- This therapy is a preferable option for patients with cardiovascular comorbidities, mitigating operative risks.
Abstract:
Specially selected 78 patients with cholelithiasis received drugs of chenodeoxycholic and ursodeoxycholic acids. Concomitant cardiovascular disorders were in 38 of them. Upon the end of the treatment course (12 months, on the average) the patients were examined and it was found that the stones disappeared in 22 of them. Follow-up evidence is available for 18 of these. Choleliths redeveloped in 9 patients (in 11 months, on the average). Of those who got free of choleliths nobody had relapses for 4.5 years. Various methods used in them to prevent lithogeny (diet, drugs) provided no evidence in favour of one of them. 9 patients with recurrent cholelithiasis after cholelitholytic therapy had no gallstone colic for 4.5 years of the follow-up. Considering the fact that preparations from cheno- and ursodeoxycholic acids are effective in only part of the patients, they seem preferable in patients with concomitant disorders (cardiovascular, etc.) to avoid a high operative risk.