[Computed X-ray tomography in predicting the efficacy of oral cholelithiasis with bile acids]

The efficacy of oral cholelitholytic therapy with chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) in 137 patients with gallstones was compared with their CT patterns. The best dissolving results were obtained from patients with the stones in isodense and faint category (< 50 Hu) on CT. All the stones with high density or heterogeneous calcification on CT were insoluble, therefore, they were contraindicated for oral cholelitholytic therapy. According to the above, criteria, the rate for dissolution ranged from 27.7% (38/137) to 66.7% (38/57), and that for complete dissolution ranged from 9.49% (13/137) to 40.7% (11/27). The attenuation value classified as complete dissolution ranged from -2 to 35 Hu(14 +/- 12 Hu, n = 13). CT analysis improved the predictability of dissolving gallstones in comparison with plain abdominal radiography or oral cholecystography (OCG). Besides, gallstones, which showed no obvious filling defect on OCG but distinct echo and shadow on B-type ultrasonography, were also insoluble.