Stones in the common bile duct: experience with medical dissolution therapy.
Thirty-one patients with radiolucent common bile duct stones received medical treatment. Nineteen had Rowachol, a terpene preparation, eight (42%) achieving complete stone disappearance within 3 to 48 months. Fifteen (including 3 of the above) took Rowachol with bile acid (chenodeoxycholic in 11, ursodeoxycholic in 4) for 3 to 60 months: 11 (73%) achieved complete dissolution within 18 months. Persistent symptoms and complications settled on conservative management: 8 (25%) patients required admission (2 biliary colic, 1 obstructive jaundice, 4 cholangitis, 1 pancreatitis). One patient died of a myocardial infarction during recovery from pancreatitis; the other continued treatment, 2 achieving complete dissolution/disappearance. Oral dissolution therapy with Rowachol and bile acids should be considered when endoscopic sphincterotomy or surgery is not feasible, but careful attention to potential complications is required while stones persist.
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D004338:Drug Combinations / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D042882:Gallstones / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D008297:Male; D008875:Middle Aged; D039821:Monoterpenes; D009822:Oils, Volatile / Q000627:therapeutic use*; D013729:Terpenes / Q000627:therapeutic use*; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D004338:Drug Combinations; D039821:Monoterpenes; D009822:Oils, Volatile; D013729:Terpenes; D002635:Chenodeoxycholic Acid; C018655:Rowachol; D014580:Ursodeoxycholic Acid; D000469:Alkaline Phosphatase