[Per oral gallstone dissolution therapy]

In this paper the author describe present status and problems of Per oral cholesterol gallstone dissolution therapy by bile acid. 1) Both ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) decrease the cholesterol output in bile, but their action mechanism somewhat differs. 2) Clinical results of UDCA treatment in our hospital during past 17 years are as follows. Complete dissolution rate Approx. 20% Partial dissolution rate Approx. 20% 3) In the attempt to increase the complete dissolution rate, bedtime administration method (one time administration instead of 3 times, every day), combination therapy of UDCA and CDCA and UDCA plus simvastatin (HMG-CoA reductase inhibitor) were tried. The results of these trial were not superior compared with ordinary UDCA therapy (3 times after each meal administration). 4) The author concluded from the results that small size (< 1 cm in diameter), Ia in ultrasonographic classification, floating by oral cholecystography, and radiolucent gallstones are the most suited for bile acid dissolution therapy.