Management of gallstones. The new option of bile acid therapy

Recent approval of chenodiol by the Food and Drug Administration has given physicians a new choice of therapy for silent gallstones, but it also presents a dilemma. The longest double-blind study of the drug in one patient population covered only two years and two dosages; no equally controlled data are available documenting drug safety beyond that period or at higher dosages. Recurrence of gallstones after discontinuation of dissolution therapy is common, and thus chronic treatment may be needed. Only the future can tell what place bile acid therapy will assume in the management of gallstone disease.