Cholesterol Gallstone Dissolution

Abstract

Cholesterol gallstone disease is characterized by secretion of bile saturated or supersaturated with cholesterol. This abnormality is usually associated with a decrease in the total bile acid pool and may be related to a hepatic defect in bile acid synthesis. Bile acid depletion induced by ileal disease or resection or increased biliary cholesterol secretion in obesity may also predispose to this disease. Oral administration of chenodeoxycholic acid results in bile unsaturated with cholesterol and after six months of treatment, 11 of 18 patients have demonstrated a decrease in gallstone size. An earlier trial on seven women for one or two years showed total stone dissolution in three and partial dissolution in three of the remaining four. Further work is needed and planned.