Untersuchungen zur Gallensteinauflösung in vivo. Studien über den Effekt von Chenodesoxycholsäure auf Gallensteine, Lithogenität der Galle und Serumlipide beim Menschen
Chenodeoxycholic acid (CDCA) was administered for an average of 15 months to 14 patients with gall-stones. The gall-stones were radiolucent in all but one instance (solitary calcified stone). Stones dissolved completely after 12 and 15 months of therapy, respectively, in two patients, while in four the size of the stones diminished. No change occurred in the remaining patients. In five patients multiple stones dissolved, while in one a radiolucent solitary stone dissolved. In one patient, with a negative cholecystogram for a time before being treated with CDCA, the gall-bladder perforated while on treatment. CDCA was well tolerated by all patients: upper abdominal discomfort disappeared during CDCA treatment in two patients and improved in nine. Only side-effect was occasional mild diarrhoea in five patients. Bile was analysed in seven patients, supersaturation with cholesterol being found in five. Biliary lipid composition became normal during CDCA treatment in these five patients. Serum triglyceride levels fell during CDCA administration in ten of eleven patients in which serum measurements were made; the greatest fall occurred in the five patients with hypertriglyceridaemia. The fall in triglyceride levels was associated with a diminution of the pre-beta-lipo-protein fraction and the chylomicron fraction. No significant change occurred in serum cholesterol levels.
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