Ursodeoxycholic acid treatment of gallstones

Although data must be gleaned from international studies representing a broad range of dosage, duration of therapy, and details reported, sufficient evidence exists to state that UDCA is approximately as effective as CDCA in dissolving gallstones. Complete stone dissolution can be expected in a majority of well-selected patients treated with 10 to 15 mg/kg/day. Additional data on potential toxicity are needed, but current evidence suggests that this is very low. Treatment will be required for 1 to 2 years in most patients. Recurrence is emerging as an important aspect which needs a solution. Clearly, stone dissolution therapy is the treatment of choice in patients with a high operative risk and stones with radiologic characteristics suggesting a high probability of success. The proper place of this management modality in the therapy of the remaining majority of patients with gallstones will require careful assessment of potential benefit in each individual patient, the known risks, and the potential of as yet unrecognized long-term toxicity.