Medical dissolution of gallstones by ursodeoxycholic acid: a clinical trial on 14 patients

Fourteen patients with radiolucent gallstones proved by oral cholecystography (OC) and ultrasonography were treated with daily doses of 600 mg of ursodeoxycholic acid (UDCA) for one year. Among them, 2 patients had complete dissolution of gallstones and another one had partial dissolution. The success rate was 21.4% (3/14). Of the remaining 11 patients who failed to respond to UDCA treatment, calcifications of varied degrees were demonstrated in every gallstone by computed tomography (CT). None of these 14 patients had statistically significant changes in serum lipids, liver function tests and hemograms during the course of treatment and only one (7.1%) patient had transient diarrhea. It was concluded that UDCA was effective and safe for medical dissolution of non-calcified gallstones. However, the underestimation of the calcification of gallstones by OC precluded successful medical dissolution by UDCA. Therefore, meticulous selection of non-calcified gallstones by CT rather than OC as candidates for dissolution may improve the success rate.