Treatment of radiolucent gallstones with CDCA or UDCA. A multicenter trial

Patients with radiolucent gallstones (diameter less than 1.5 cm) and functioning gallbladder were treated for 6-12 months with CDCA (38 patients, 12-15 mg/kg/day) or UDCA (78 patients randomly allocated to receive 5-6 or 10-12 mg/kg/day). Complete dissolutions and partial plus complete dissolutions were respectively 26 and 58% for CDCA, 14 and 58% for UDCA at the lower dose, and 29 and 71% for UDCA at the higher dose. Statistical analysis did not show any significant difference between the three different treatments. In patients with stones of 4-10 mm diameter treated with UDCA, complete dissolution occurred at the lower dose in 0 of 14 cases while complete dissolutions occurred at the higher dose in 5 of 18 cases, suggesting that the latter dose may be more effective (0.05 less than P less than 0.1). A highly significant correlation was demonstrated between gallstone size and number of dissolutions with both doses of UDCA. No side effects were observed with UDCA, while with CDCA diarrhea occurred in 28% and a transient increase in SGOT in a single patient. 1 patient on UDCA required emergency cholecystectomy for acute cholecystitis. Dyspeptic and/or pain symptom-atology improved in 65 and 85% of the patients treated with CDCA and UDCA, respectively. No variations in the blood lipids were observed.