Criteria for Selection of Patients for Medical Treatment (Chenodeoxycholic Acid Therapy) of Gallstones

Abstract

With the introduction of medical treatment (chenodeoxycholic acid therapy) of cholesterol gallstones, the prediction of the gallstone type, cholesterol — non-cholesterol stones (i.e. cholesterol predominating or not), has become important. In 24 consecutive patients admitted for surgery because of gallstones, the value of various criteria for differentiation between the two types of stones was assessed. It is concluded that the combined requirements of radiolucency of the stones and a cholesterol saturation index in duodenal bile above 1.00 constitutes a fairly reliable method for selection of patients for dissolution therapy with chenodeoxycholic acid.

Key-words:

• Biliary cholesterol saturation index
• biliary lipid composition
• chenodeoxycholic acid therapy
• cholesterol gallstones
• duodenal bile
• gallbladder bile
• non-cholesterol gallstones
• prediction of gallstone type
• radiography