Efficacy and Specificity of Chenodeoxycholic Acid Therapy for Dissolving Gallstones

Abstract

In a controlled trial, 53 patients with asymptomatic radiolucent gallstones in functioning gallbladders were treated with chenodeoxycholic acid, cholic acid or placebo. At six months, 11 of 18 patients receiving chenodeoxycholic acid had a decrease in gallstone size or number, but no response was observed in the 17 treated with cholic acid or in the 18 receiving placebo. Of seven others on chenodeoxycholic acid for two to three years, three had no gallstones, and three had continuing reduction in gallstone size. Of 13 patients with radiopaque gallstones only two responded to chenodeoxycholic acid. About one quarter of those ingesting chenodeoxycholic acid had transiently elevated serum glutamic oxalacetic transaminase, but no other abnormalities in liver function. Liver biopsies from eight patients were normal; three patients had minor changes. Chenodeoxycholic acid continues to appear to offer a specific medical treatment for asymptomatic radiolucent gallstones in functioning gallbladders. (N Engl J Med 289:655–659, 1973)