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[Conservative cholelitholysis in the calculus-congested gallbladder].

W Swobodnik, O Müller, J G Wechsler

    Deutsche Medizinische Wochenschrift (1946)
    |May 29, 1987
    PubMed
    Summary
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    Ursodeoxycholic acid and chenodeoxycholic acid dissolved gall-bladder stones in a patient with severe heart disease over 14 months. Drug therapy is a viable option for gallstone dissolution when surgery poses high risks.

    Area of Science:

    • Gastroenterology and Hepatology
    • Pharmacology

    Background:

    • Gallstones (cholelithiasis) are common, often asymptomatic, but can cause significant morbidity.
    • Surgical cholecystectomy is the standard treatment, but carries risks, especially in patients with comorbidities.
    • Medical dissolution therapy offers a non-surgical alternative for select patients.

    Observation:

    • A 60-year-old male patient with severe coronary heart disease, contraindicating surgery, was treated for gallstones.
    • The patient received daily oral administration of ursodeoxycholic acid and chenodeoxycholic acid (500 mg total, divided doses).
    • Treatment involved 8.5 mg/kg body weight of the substances over a 14-month period.

    Findings:

    • Complete dissolution of all gall-bladder concrements (stones) was achieved.

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  • The medical therapy was well-tolerated in this high-risk patient.
  • Treatment duration was 14 months for complete gallstone dissolution.

    • Implications:

    • This case supports the use of ursodeoxycholic acid and chenodeoxycholic acid for gallstone dissolution in patients with high surgical risk.
    • Pharmacological treatment can be a safe and effective alternative to surgery in specific clinical scenarios.
    • Further research into long-term efficacy and patient selection for medical gallstone dissolution is warranted.