[Effect of chenodeoxycholic acid in cholesterol lithiasis]

Area of Science:

• Gastroenterology
• Hepatology
• Pharmacology

Background:

• Gallstones (cholelithiasis) are a common condition.
• Radiolucent gallstones are often treated medically when possible.

Purpose of the Study:

• To evaluate the efficacy and safety of chenodeoxycholic acid (CDCA) for dissolving gallstones.
• To assess long-term recurrence rates after successful dissolution.

Main Methods:

• Administered CDCA to 62 patients with radiolucent gallstones.
• Monitored stone size, treatment success, adverse events, and liver function tests.
• Performed hepatic biopsies on 48 patients.
• Followed up on recurrence rates in patients with complete remission.

Main Results:

• Complete dissolution in 27 patients (43.5%) and partial reduction in 14 patients (22.6%).
• Overall treatment success rate of 68.33%.
• Minimal adverse effects, primarily transient diarrhea and mild, reversible elevations in liver enzymes (SGOT, SGPT, GT).
• No histologic abnormalities found on hepatic biopsies.
• No recurrence in patients treated with 500 mg/day or every other day CDCA post-dissolution.
• Recurrence observed in patients with infrequent dosing or interrupted treatment.

Conclusions:

• CDCA is an effective treatment for radiolucent gallstones with a good safety profile.
• Sustained treatment or appropriate maintenance dosing appears crucial for preventing recurrence.
• Further research into optimal dosing and long-term management is warranted.