In a controlled trial, 53 patients with asymptomatic radiolucent gallstones in functioning gallbladders were treated with chenodeoxycholic acid, cholic acid or placebo. At six months, 11 of 18 patients receiving chenodeoxycholic acid had a decrease in gallstone size or number, but no response was observed in the 17 treated with cholic acid or in the 18 receiving placebo. Of seven others on chenodeoxycholic acid for two to three years, three had no gallstones, and three had continuing reduction in gallstone size. Of 13 patients with radiopaque gallstones only two responded to chenodeoxycholic acid. About one quarter of those ingesting chenodeoxycholic acid had transiently elevated serum glutamic oxalacetic transaminase, but no other abnormalities in liver function. Liver biopsies from eight patients were normal; three patients had minor changes. Chenodeoxycholic acid continues to appear to offer a specific medical treatment for asymptomatic radiolucent gallstones in functioning gallbladders. (N Engl J Med 289:655–659, 1973)
Supported in part by research grants (AM-15887, AM-16770 and AM-6908) from the National Institutes of Health, U. S. Public Health Service, and a grant-in-aid from the Mead Johnson Company.
Presented in part at the annual meeting of the American Society for Clinical Investigation,1 Atlantic City, N. J., Apr. 29 and 30, 1973, and the American Gastroenterological Association,2 New York, N. Y., May 20–26, 1973.
We are indebted to our former colleague, Dr. Leslie J. Schoenfield, for helpful discussions, to Dr. Peter D. Klein, Miss Patricia A. Szczepanik and Dr. Jan Sj?vall for mass spectrometric analyses, to Dr. Archie H. Baggenstoss for interpretations of liver biopsies, to Dr. Michael Redcliffe Lee for unpublished data, to Mrs. Beverly J. Ott and Don T. Belobaba for technical assistance, and to our colleagues in the Department of Diagnostic Roentgenology, Drs. Harley C. Carlson and John R. Hodgson, for advice.