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Gallstone decalcification and dissolution using chenodeoxycholate and citrate.

A Sali1, L Vitetta

  • 1Department of Surgery, University of Melbourne, Repatriation General Hospital, Heidelberg, Victoria, Australia.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
|January 1, 1990
PubMed
Summary
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Oral citrate combined with chenodeoxycholic acid (C.D.C.A.) shows potential for dissolving calcified gallstones. This treatment achieved partial or complete decalcification in some patients, offering a new avenue for gallstone dissolution therapy.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Pharmacology

Background:

  • Gallstone dissolution is limited to specific patient groups.
  • Calcified or large gallstones are generally unsuitable for dissolution therapies.
  • Citrate, a natural bile component, can be increased in bile via oral supplementation.

Purpose of the Study:

  • To investigate the efficacy of combining chenodeoxycholic acid (C.D.C.A.) with citrate for gallstone dissolution.
  • To assess the potential of oral citrate in decalcifying calcified gallstones.

Main Methods:

  • Patients with calcified or large gallstones received treatment with a combination of C.D.C.A. and citrate.
  • A subset of patients who did not respond to C.D.C.A. alone were also treated with the C.D.C.A. and citrate combination.

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Main Results:

  • Partial decalcification occurred in 35% (7/20) of patients with calcified stones.
  • Complete decalcification was observed in 20% (4/20) of patients with calcified stones.
  • One patient with large gallstones achieved complete dissolution; another non-responder patient also experienced complete dissolution.

Conclusions:

  • Oral citrate can contribute to the decalcification of certain calcified gallstones.
  • The combination of C.D.C.A. and citrate demonstrates promise for treating specific types of gallstones, including calcified and large ones.