Clinical, ultrasonographic, and roentgenographic study in 134 asymptomatic gallstone carriers. Is oral ursodeoxycholic acid treatment worthwhile?

• Published in: Scandinavian journal of gastroenterology Vol. 28; no. 3; p. 267
• Main Authors: Lirussi, F, Passera, D, Iemmolo, R M, Nassuato, G, Okolicsanyi, L
• Format: Journal Article
• Language: English
• Published: England 01.03.1993
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Cholecystography; Cholelithiasis - diagnostic imaging; Cholelithiasis - drug therapy; Double-Blind Method; Female; Gallbladder - diagnostic imaging; Humans; Male; Middle Aged; Prospective Studies; Retrospective Studies; Ultrasonography; Ursodeoxycholic Acid - administration & dosage; Ursodeoxycholic Acid - adverse effects
• ISSN: 0036-5521
• DOI: 10.3109/00365529309096084

We investigated retrospectively the ultrasonographic and roentgenographic characteristics of the gallstones and the gallbladder in 134 symptom-free carriers and evaluated prospectively the outcome and side effects of 6 to 24 months' ursodeoxycholic acid (UDCA) therapy in 36 individuals with silent stones. Two-thirds of the 134 subjects had multiple stones, and 71-75% had stones less than 15 mm in diameter. Gallstone calcification was detected in 13%. A non-functioning gallbladder was observed in 19%, whereas gallbladder contraction was normal in 64 of 76 gallstone carriers. With regard to oral bile acid treatment, complete and partial dissolutions were achieved in 7 and 9 of 33 subjects, respectively (48.5%). Development of a non-functioning gallbladder occurred in 9%, and acquired gallstone calcification was seen in another 15%. We conclude that: i) the characteristics of the gallstones and the gallbladder are similar to those observed in symptomatic patients, and ii) UDCA therapy may be given in selected symptom-free carriers for no more than 6-12 months. Thereafter, it does not appear to be cost-effective.