Abstract
In order to achievea better result of bile acid dissolutionth erapy (BADT), we have established a new protocolf or patient selectionu sing the combinationof our ultrasonographic classification with CT findingso fg allstonesP. atients received 600mg of ursodeoxycholiacc idp er day, as a single bedtimed ose. Based on our protocol, we performedp rospectivelyB ADT for 41 patientsw ith CT -radiolucentm ultiples tones. Furthermore, we performedr etrospectivelya matchedc ase-control study to evaluate the efficacy of stone clearance in the patients with ≥ 2 stones in number between BADT and extracorporeal shock-wave lithotripsy (ESWL). According to the method of Kaplan-Meier, a cumulative rate for complete (complete plus partial) clearance by BADT was 20 % (85 %)at a year and 45 % (100 %) at 2 years. No significant difference in stone clearance was noted between BADT and ESWL. The rate of biliary colic during the periods of treatment occurred at a significantly lower rate in the BADT-patients than in the ESWL-patients.
We conclude that BADT appears to be the first option to treat the patients with multiple stones, especially those with ≥ 5 stones in number. Our new protocol of BADT for multiple stohes is considered usetul and cost-effective to achieve a better result of stone clearance.
