Bile salts and gallstone disease

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Abstract
Bile salts play an important role in maintaining cholesterol in aqueous solution in bile. There is evidence that in some patients at least gallstones arise as a result of bile salt deficiency. The evidence to date suggests that although oral bile salts may be of use in treating some gallstone patients they are unlikely to replace chole-cystectomy in the foreseeable future. The instillation of bile salts via an indwelling T-tube may well be of great use in the management of stones retained in the common duct after choledocholithotomy. There is no doubt that in this branch of medicine as in all others prevention is better than cure and our aim should be to perfect our technique so that we do not leave stones behind. However, should the situation occur we may soon have safe effective physiological solvents to dissolve our mistakes.