Chenotherapy for gallstone dissolution. I. Efficacy and safety

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Abstract
Clinical experience with chenodeoxycholic acid therapy for dissolving gallstones is reported, with particular attention to determinants of response. Of 12 patients receiving 15 mg/kg per day or more, 10 responded (83%); only 15 of 40 patients (38%) receiving less than 15 mg/kg per day responded. Large solitary stones and stones in gallbladders that visualized poorly after oral cholecystography had a lower response rate. Radiopaque stones did not respond in 18 patients. Five of 10 patients with stones in the common bile duct responded. Small dose-related elevations in SGOT [serum glutamic oxaloacetic transaminase] were the only biochemical abnormality observed. Liver biopsy specimens showed no notable abnormality. Diarrhea was an infrequent problem. Stones recurred in 3 of 15 patients during 6-48 mo. of observation without treatment. Chenodeoxycholic acid, when given in adequate dosage, continues to appear promising as medical therapy for asymptomatic radiolucent gallstones in radiologically visualizing gallbladders.