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Gall stone recurrence and its prevention: the British/Belgian Gall Stone Study Group's post-dissolution trial
K A Hood1, D Gleeson, D C Ruppin
1Gastroenterology Unit, UMDS of Guy's Hospital, London.
Gut
|September 1, 1993
Summary
Low-dose ursodeoxycholic acid may reduce gallstone recurrence after dissolution, but a high-fiber diet does not. NSAIDs and a longer stone-free interval are associated with lower recurrence rates.
Area of Science:
- Gastroenterology
- Hepatology
- Clinical Trials
Background:
- Gallstone recurrence is a significant concern after medical dissolution.
- Identifying effective prevention strategies is crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy of low-dose ursodeoxycholic acid and a high-fiber diet in preventing gallstone recurrence.
- To determine the timing, frequency, and predictors of gallstone recurrence.
- To compare diagnostic methods for recurrent gallstones.
Main Methods:
- Prospective, multicenter, randomized, double-blind trial.
- Follow-up of 93 patients for up to five years using ultrasonography and oral cholecystography.
- Analysis of recurrence rates, associated symptoms, and risk factors.
Main Results:
- 21 recurrences were detected; only two were symptomatic.
- Recurrence rates at 42 months were 21.9% for ursodeoxycholic acid, 27.4% for placebo, and 45.8% for diet.
- Non-steroidal anti-inflammatory drugs (NSAIDs) and a stone-free interval >9 months were associated with reduced recurrence.
Conclusions:
- A high-fiber, low-refined carbohydrate diet does not reduce gallstone recurrence.
- Low-dose ursodeoxycholic acid may lower, but not eliminate, the risk of recurrence.
- A longer stone-free interval post-dissolution is a significant protective factor.