Recurrence and re-recurrence of gall stones after medical dissolution: a longterm follow up

One hundred patients with radiolucent gall stones less than or equal to 1.5 cm in functioning gall bladders have received oral bile acid dissolution therapy since 1975. Complete data are available on 93 who have received at least six months' treatment. The complete dissolution rate in appropriately selected patients who complied with and tolerated an adequate course of treatment was 55%. By life table analysis the recurrence rates were 13% at one year, 21% at two years, 31% at three years, and 43% at four years. Thereafter the recurrence rate levelled out, being 49% at 11 years. Redissolution was achieved in all seven patients who had a second course of therapy, but was usually followed by re-recurrence. Patients whose gall stones recurred did not differ significantly from those who remained stone free with respect to age, sex, body weight, or time required for dissolution.