The Medical Treatment of Cholesterol Gallstones: Experience with Chenodeoxycholic Acid

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Abstract
Chenodeoxycholic acid was administered to 50 patients with cholelithiasis and 8 with choledocholithiasis for a period of 15 mo. at doses varying between 2- and 15 mg per kg/day. Among the 50 patients with cholelithiasis, complete dissolution occurred in 16 and partial dissolution in 15 cases. Among the 8 patients with choledocholithiasis, complete dissolution occurred in 3 and partial dissolution in 2 cases. Lower doses were adopted to determine the minimum effective daily dose required to produce gallstone dissolution and to lower the cholesterol saturation index (mean 1.52 .+-. 0.73 before and 0.98 .+-. 0.36 after treatment). Routine liver function tests were carried out before, during and after treatment; no significant alterations were produced by therapy. Studies of the antipyrine half-life, to estimate hepatic microsomal function were found to be normal (mean 13.61 .+-. 2.62 before and 13.21 .+-. 3.04 after treatment). In addition, histological investigations of the liver were described. The efficacy of chenodeoxycholic acid in the treatment of cholesterol gallstones is confirmed and gives an indication of the minimum effective dose (7.8 mg per kg/day). At the present doses, there are no substantial modifications in fundamental liver function.