title: Anisodamine accelerates spontaneous passage of single symptomatic bile duct stones ≤ 10 mm.
abstract: OBJECTIVE
  To investigate the rate of spontaneous passage of single and symptomatic common bile duct (CBD) stones ≤ 10 mm in diameter in 4 wk with or without a 2-wk course of anisodamine.
  
  
  METHODS
  A multicenter, randomized, placebo-controlled trial was undertaken. A total of 197 patients who met the inclusion criteria were enrolled. Ninety-seven patients were assigned randomly to the control group and the other 100 to the anisodamine group. The anisodamine group received intravenous infusions of anisodamine (10 mg every 8 h) for 2 wk. The control group received the same volume of 0.9% isotonic saline for 2 wk. Patients underwent imaging studies and liver-function tests every week for 4 wk. The rate of spontaneous passage of CBD stones was analyzed.
  
  
  RESULTS
  The rate of spontaneous passage of CBD stones was significantly higher in the anisodamine group than that in the control group (47.0% vs 22.7%). Most (87.2%, 41/47) stone passages in the anisodamine group occurred in the first 2 wk, and passages in the control group occurred at a comparable rate each week. Factors significantly increasing the possibility of spontaneous passage by univariate logistic regression analyses were stone diameter (< 5 mm vs ≥ 5 mm and ≤ 10 mm) and anisodamine therapy. Multivariate logistic regression analyses revealed that these two factors were significantly associated with spontaneous passage.
  
  
  CONCLUSIONS
  Two weeks of anisodamine administration can safely accelerate spontaneous passage of single and symptomatic CBD stones ≤ 10 mm in diameter, especially for stones < 5 mm.
authors.affiliation: Jun Gao, Xue-Mei Ding, Shan Ke, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Ding
authors.forename: Shan
authors.initials: S
authors.lastname: Ke
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Zhou
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Qian
authors.forename: Rui-Liang
authors.initials: RL
authors.lastname: Ma
authors.forename: Chun-Min
authors.initials: CM
authors.lastname: Ning
authors.forename: Zong-Hai
authors.initials: ZH
authors.lastname: Xin
authors.forename: Wen-Bing
authors.initials: WB
authors.lastname: Sun
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002681:China; D049448:Cholangiopancreatography, Magnetic Resonance; D042883:Choledocholithiasis / Q000175:diagnosis / Q000188:drug therapy*; D003135:Common Bile Duct / Q000187:drug effects* / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008111:Liver Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012991:Solanaceous Alkaloids / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012991:Solanaceous Alkaloids; C003922:anisodamine
keywords: Anisodamine; Common bile duct stones; Randomized controlled trial; Spontaneous passage; Success rate