Clinical Studies on Gallstone Dissolution by Chenodeoxycholic Acid

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We studied the effect of chenodeoxycholic acid (CDCA) on gallstone dissolution in 18 patients with radiolucent gallstones. They received CDCA in daily doses of 300 to 600mg over a period of 5 to 16 months. Gallstone dissolution was noted in four of 18 patients studied (22.2%), and improvement of symptoms was achieved in some patients. When radiolucent stones smaller than 5mm in diameter were found in normally functioning gallbladders, the therapy was usually effective. There was no definite clinical evidence of hepatotoxicity due to the use of CDCA, although some patients developed transient elevation of transaminase activity. Four patients (22.2%) experienced diarrhea during treatment. At daily doses of 300mg, all of these untoward effects appeared to be transient, and were resolved without discontinuance of CDCA. Even at this low dose, CDCA increased cholesterol solubility in the bile, and effectively dissolved gallstones in a comparable proportion of patients. Therefore, we believe that long-term low dose CDCA therapy can be considered a safe, tolerable, and effective mode of therapy for gallstone dissolution.
東海大学の論文