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HPB Surgery
Volume 3, Issue 1, Pages 59-65
http://dx.doi.org/10.1155/1990/96130

Gallstone Decalcification and Dissolution Using Chenodeoxycholate and Citrate

1Department of Surgery, The University of Melbourne, Repatriation General Hospital, Heidelberg, Victoria 3081, Australia
2University Department of Surgery, Repatriation General Hospital, Heidelberg, Victoria 3081, Australia

Received 29 March 1990

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gallstone dissolution may be possible only in selected patients. Patients with calcified or large gallstones are not suitable for dissolution. Citrate is normally present in bile and an oral citrate load can increase biliary citrate.

A combination of chenodeoxycholic acid (C.D.C.A.) and citrate has been shown to dissolve calcified cholesterol gallstones in vitro. Patients with calcified or large gallstones were treated with a combination of C.D.C.A. and citrate. Partial decalcification was achieved in seven out of twenty patients with calcified stones (35%) and complete decalcification in four patients (20%). One of the patients with large stones had complete dissolution.

Five patients who were suitable for C.D.C.A. treatment but did not respond were also treated with C.D.C.A. and citrate. One of the patients in this latter group had complete dissolution. Oral citrate can decalcify some calcified gallstones.