Comparison of fixed doses of chenodeoxycholic acid for gallstone dissolution

96 patients with gallstones have been treated for up to four years with chenodeoxycholic acid in daily doses of 500, 750, or 1000 mg. None of the patients started on 500 mg daily showed complete gallstone dissolution. 8 out of 41 patients on 750 mg daily had complete dissolution of their radiolucent gallbladder stones after six or more months, and a further 4 showed partial dissolution. 5 out of 28 patients on 1000 mg daily had complete dissolution of their radiolucent gallbladder stones after at least six months, and a further 9 showed partial gallstone dissolution. The mean duration of therapy was greater on 750 mg than on 1000 mg/day (1.27 vs. 0.58 years), and when results were analysed after the first six months' therapy the total response-rate was significantly greater for the 1000 mg dose (12 out of 28) than for the 750 mg dose (9 out of 41). The individual response of radiolucent gallabladder stones to therapy could not be predicted from stone size, weight of patient, dosage/kg, orchange in biliary lipids. Treatment of radiolucent gallstones with chenodeoxycholic acid should start at 1000 mg daily.