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Clinical studies on dissolution of gallstones using ursodeoxycholic acid

Summary

Ursodeoxycholic acid (UDCA), 7β hydroxy epimer of chenodeoxycholic acid (CDCA), has been used as a choleretica for 20 years in Japan. Recent report showing increased excretion of UDCA in bile after CDCA administration may suggest the possibility that UDCA has similar effects to CDCA on bile cholesterol unsaturation and on gallstone dissolution. The present paper describes the clinical usefulness of UDCA for gallstone patients during the past two years. Seventy-four gallstone patients with functioning gallbladders, 19 men and 55 women with a mean age of 48 years, have been treated for 6 months or more. UDCA, supplied in tablets (Ursosan®), was given 450 mg per day. The disappearance or the reduction of stone size or number, or both (dissolution effect) was recognized in 32 out of 74 patients (43%). In case of radiolucent stones, the overall effective rate was estimated for 24 of 46 patients (52%). There may be no significant difference in dissolution effect between CDCA and UDCA treatment, however, the merit of UDCA treatment seems to have its few side effects.

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References

  1. 1)

    Vlahcevic ZR, et al: Diminished bile acid pool size in patients with gallstones. Gastroenterology 59: 165, 1970

    PubMed  CAS  Google Scholar 

  2. 2)

    Almond HR, et al: Bile acid pools, kinetics and biliary lipid composition before and after cholecystectomy. New Engl J Med 289: 1213, 1973

    PubMed  CAS  Article  Google Scholar 

  3. 3)

    Danzinger RG, et al: Dissolution of cholesterol gallstones by chenodeoxycholic acid. ibid 286: 1, 1972

    PubMed  CAS  Google Scholar 

  4. 4)

    Bell GD, et al: Gallstone dissolution in man using chenodeoxycholic acid. Lancet 2: 1213, 1972

    PubMed  CAS  Google Scholar 

  5. 5)

    Bainton D, et al: Chenodeoxycholic acid and the liver. ibid 1: 562, 1974

    CAS  Google Scholar 

  6. 6)

    Flügel H: Auflösung von Gallensteinen mit Chenodeoxycholsäure. Fortschr Med 92: 272, 1974

    PubMed  Google Scholar 

  7. 7)

    Mok HYI, et al: Effect of different doses of chenodeoxycholic acid on bile-lipid composition and frequency of side-effects in patients with gallstones. Lancet 2: 253, 1974

    PubMed  Article  CAS  Google Scholar 

  8. 8)

    Webster KH, et al: The effect of primary bile acid feeding on cholesterol metabolism and hepatic function and morphology in the rhesus monkey. Gastroenterology 65: 576, 1974

    Google Scholar 

  9. 9)

    Dyrszka H, et al: Hepatic toxicity in the rhesus monkey treated with chenodeoxycholic acid for 6 months: Biochemical and ultrastructural studies. ibid 70: 93, 1976

    PubMed  CAS  Google Scholar 

  10. 10)

    Schoenfield LJ: Medical therapy for gallstones. ibid 67: 725, 1974

    PubMed  CAS  Google Scholar 

  11. 11)

    Salen G, et al: Increased formation of ursodeoxycholic acid in patients treated with chenodeoxycholic acid. J Clin Invest 53: 612, 1974

    PubMed  CAS  Article  Google Scholar 

  12. 12)

    Sugata F, et al: Retrospective study on gallstone disappearance. Jpn J Gastroenterol 71: 75, 1974 (In Jpn)

    CAS  Google Scholar 

  13. 13)

    Makino I, et al: Dissolution of cholesterol gallstones by ursodeoxycholic acid. Jpn J Gastroenterol 72: 690, 1975 (In Jpn)

    CAS  Google Scholar 

  14. 14)

    Ashizawa S, et al: Clinical study of gallstone dissolution by ursodeoxycholic acid: A double blind observation. Igaku no ayumi 101: 922, 1977 (In Jpn)

    Google Scholar 

  15. 15)

    Iser JH, et al: Chenodeoxycholic acid treatment of gallstones: A follow-up report and analysis of factors influencing response to therapy. New Engl J Med 293: 378, 1975

    PubMed  CAS  Article  Google Scholar 

  16. 16)

    Dworken HJ: Recent experience with spontaneously disappearing gallstones. Gastroenterology 38: 76, 1960

    PubMed  CAS  Google Scholar 

  17. 17)

    Wolpers C: Spontanauflösung von Gallenblasensteinen. Dtsch Med Wschr 93: 2525, 1968

    PubMed  CAS  Article  Google Scholar 

  18. 18)

    Kameda H, et al: Spontaneous disappearance of gallstones. Saishin-igaku 27: 1113, 1972 (In Jpn)

    Google Scholar 

  19. 19)

    Nicolau G, et al: Determination of hepatic 3-hydroxy-3-methylglutaryl CoA reductase activity in man. J Lipid Res 15: 94, 1974

    PubMed  CAS  Google Scholar 

  20. 20)

    Salen G, et al: Hepatic cholesterol metabolism in patients with gallstones. Gastroenterology 69: 676, 1975

    PubMed  CAS  Google Scholar 

  21. 21)

    Adler R, et al: Effect of bile acid feeding on biliary cholesterol secretion. ibid 64: 689, 1973

    Google Scholar 

  22. 22)

    Northfield TC, et al: Biliary lipid secretion in gallstone patients. Lancet 2: 747, 1973

    Article  Google Scholar 

  23. 23)

    Danzinger RG, et al: Effect of oral chenodeoxycholic acid on bile acid kinetics and biliary lipid composition in woman with cholelithiasis. J Clin Invest 52: 2809, 1973

    PubMed  CAS  Google Scholar 

  24. 24)

    Shinozaki K, et al: Dissolution of cholesterol gallstones and change of bile acid composition in bile of patients treated with ursodeoxycholic acid. Acta Hepatologica Japonica 15: 450, 1974 (In Jpn)

    Google Scholar 

  25. 25)

    Stiehl A, et al: Veränderungen der biliären Gallensäurenzusammensetzung bei Patienten mit Cholesteringallensteinen nach Behandlung mit Ursodesoxycholsäure. 83. Tagung der Deutschen Gesellschaft für Innere Medizin, Wiesbaden, April 1977

    Google Scholar 

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Correspondence to Makoto Okumura M.D..

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Okumura, M., Tanikawa, K., Chūman, Y. et al. Clinical studies on dissolution of gallstones using ursodeoxycholic acid. Gastroenterol Jpn 12, 469–475 (1977). https://doi.org/10.1007/BF02781340

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Key Words

  • ursodeoxycholic acid (UDCA)
  • cholesterol gallstones
  • gallstone dissolution agent