[Dissolution of gallstones by chenodeoxycholic acid]

A 2-year prospective study with chenodeoxycholic acid (CDCA) (750 mg per day) was performed in 34 asymptomatic patients with radiolucent gallstones. 17 patients dropped out before completion of the trial. In 5 cases (29%) the stones dissolved and in 5 additional cases they decreased in size, while in 2 cases (13%) they increased in size during treatment. Favorable criteria for dissolution were round stones without edges and fissures on radiological appearance and a stone diameter of less than 1 cm. In 3 cases drug-induced nausea or diarrhea were so pronounced that treatment could not be continued. CDCA treatment also caused a significant rise in SGPT for at least one year. Thus, CDCA is at best moderately effective in a highly selective group of patients with gallstones.