Gallstone decalcification and dissolution using chenodeoxycholate and citrate.
Gallstone dissolution may be possible only in selected patients. Patients with calcified or large gallstones are not suitable for dissolution. Citrate is normally present in bile and an oral citrate load can increase biliary citrate. A combination of chenodeoxycholic acid (C.D.C.A.) and citrate has been shown to dissolve calcified cholesterol gallstones in vitro. Patients with calcified or large gallstones were treated with a combination of C.D.C.A. and citrate. Partial decalcification was achieved in seven out of twenty patients with calcified stones (35%) and complete decalcification in four patients (20%). One of the patients with large stones had complete dissolution. Five patients who were suitable for C.D.C.A. treatment but did not respond were also treated with C.D.C.A. and citrate. One of the patients in this latter group had complete dissolution. Oral citrate can decalcify some calcified gallstones.
Sali
A
A
Department of Surgery, University of Melbourne, Repatriation General Hospital, Heidelberg, Victoria, Australia.
Vitetta
L
L
D000328:Adult; D000368:Aged; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use*; D002769:Cholelithiasis / Q000628:therapy*; D002784:Cholesterol; D002951:Citrates / Q000627:therapeutic use*; D003648:Decalcification Technique; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D002951:Citrates; D002635:Chenodeoxycholic Acid; D002784:Cholesterol