Is recurrence inevitable after gallstone dissolution by bile-acid treatment?

Gallstone dissolution was observed on 60 occasions in 54 patients; in 6, recurrent stones were dissolved by a second course of medical treatment. When complete gallstone dissolution was confirmed (by two consecutive cholecystograms, 3 months apart) bile-acid treatment was stopped, and the patients w...

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Bibliographic Details
Published inThe Lancet (British edition) Vol. 1; no. 8265; p. 181
Main Authors Ruppin, D C, Dowling, R H
Format Journal Article
LanguageEnglish
Published England 23.01.1982
Subjects
Adult
Aged
Bile Acids and Salts - metabolism
Chenodeoxycholic Acid - therapeutic use
Cholelithiasis - drug therapy
Cholelithiasis - surgery
Cholesterol - metabolism
Deoxycholic Acid - analogs & derivatives
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recurrence
Sex Factors
Solubility
Time Factors
Ursodeoxycholic Acid - therapeutic use
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Summary:Gallstone dissolution was observed on 60 occasions in 54 patients; in 6, recurrent stones were dissolved by a second course of medical treatment. When complete gallstone dissolution was confirmed (by two consecutive cholecystograms, 3 months apart) bile-acid treatment was stopped, and the patients were followed for up to 71/2 years with oral cholecystograms taken annually (or sooner if symptoms suggested early recurrence). Recurrence was detected 30 times after the 60 episode of gallstone dissolution (50%), in 25 of the 54 patients (46%), and in 25 of 46 patients who had had at least one post-dissolution X-ray before recurrence (54%). In 21 of these 25 patients (84%) the recurrence was observed within 2 years of treatment being stopped. There were no significant differences in clinical details and pre-treatment gallstone characteristics between the 25 gallstone-recurrent (at any time) and the 29 gallstone-free (at the time of study) patients, nor between a subgroup of patients in whom recurrent stones developed rapidly (less than or equal to 1 year) and a subgroup who remained gallstone-free for 3 years. It is concluded that long-term follow-up is advisable and that post-dissolution treatment will be necessary to prevent gallstone recurrence.
ISSN:0140-6736