Ursodeoxycholic Acid: A Safe and Effective Agent for Dissolving Cholesterol Gallstones

Abstract

Ursodeoxycholic acid, 250-300, 500-600 or 900-1000 mg/day, was given orally for 6-38 mo. to 53 patients with cholesterol gallstones and functioning gallbladders; 42 patients had > 50% reduction in gallstone volume and/or number without apparent dose dependence and 27 of these patients had complete gallstone dissolution. Results of laboratory studies including liver function tests were not affected adversely and biliary lithocholic acid concentration did not increase during therapy. Most biliary symptoms seemed to disappear within 3 mo. and no patient developed diarrhea. Large diameter and increased number of gallstones were found to hinder dissolution. The percentage of biliary ursodeoxycholic acid increased with increasing dose and reached a maximum of 50-60% of total bile acids at a dose of .apprx. 10-12 mg/kg body wt per day. Biliary lithogenic index was reduced significantly during treatment with ursodeoxycholic acid 500-600 and 900-1000 mg/day. Ursodeoxycholic acid appears to be a safe and effective alternative to surgery in selected patients with gallstones.