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Q J Med 1975; 44: 349-367
© 1975 Association of Physicians

research-article

Chenodeoxycholic Acid Therapy for Gallstones: Effectiveness, Toxicity and Influence on Bile Acid Metabolism

OLIVER JAMES, J. CULLEN and IAN A. D. BOUCHIER

Department of Medicine, Royal Free Hospital Gray's Inn Road, London WC1X 8LF, England

Received 6 June 1974 Chenodeoxycholic acid (1 g daily) was administered to 10 patients with gallstones and three patients with biliary stricture and recurrent cholangitis. Four gallstone patients showed diminution or disappearance of stones including one patient whose stone was in the common bile duct. The patients with recurrent cholangitis showed marked improvement in symptoms during treatment.

Serum bile acid levels were significantly elevated in 8 gallstone patients during treatment. Liver biopsy in eight gallstone patients during treatment revealed minor changes in five.

Lithocholic acid and bile acid sulphates were found in only small amounts in the bile of patients during treatment.

No significant trend in biliary lipid composition during treatment was observed. There was no overall trend in the group of patients whose stones disappeared or diminished.

Changes in biliary bile acid composition and in bile acid pool sizes were variable following treatment and could not be correlated with the clinical results of treatment.

A further trial of chenodeoxycholic acid is recommended in patients with stones in the biliary tree and recurrent cholangitis who are not amenable to surgical treatment.


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L. J. SCHOENFIELD, J. M. LACHIN, R. A. BAUM, R. L. HABIG, R. F. HANSON, T. HERSH, N. C. HIGHTOWER Jr., A. F. HOFMANN, E. C. LASSER, J. W. MARKS, et al.
Chenodiol (Chenodeoxycholic Acid) for Dissolution of Gallstones: The National Cooperative Gallstone Study: A Controlled Trial of Efficacy and Safety
Ann Intern Med, September 1, 1981; 95(3): 257 - 282.
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