Dissolution of cholesterol gallstones by ursodeoxycholic acid

Abstract

Eleven patients with presumed cholesterol gallstones were given 0.45 to 2.0g per day of ursodeoxycholic acid during 4 months to one and half year.
In case 1, multiple stones have disappeared after 7 months of the treatment. In case 2, multiple stones progressively diminished. In case 3, a small one of two gallstones has disappeared after 4 months of the treatment. In case 4, a single stone progressively grew smaller. The decision concerning to dissolution of multiple stones in case 5 is under discussion. While, in 6 patients with gallstone, there was no change in gallstone size.
During the treatment, liver function test and serum cholesterol remained normal, and none of patients had anorexia, diarrhea and attack of pain.
In three patients, bile lipid composition was measured before and after bile acid therapy. Ursodeoxycholic acid treatment significantly improved cholesterol solubility in bile by a reduction in molar ratio of cholesterol in bile. After the treatment, the major bile acid in bile was ursodeoxycholic acid, which occupied abcve 40% of total bile acid, and dihydroxy-cholanoic acid consisting of chenodeoxycholic and ursodeoxycholic acid made up 80% of total biliary bile acid.