Comparison on response and dissolution rates between ursodeoxycholic acid alone or in combination with chenodeoxycholic acid for gallstone dissolution according to stone density on CT scan: Strobe compliant observation study

Jae Min Lee, Jong Jin Hyun, In Young Choi, Suk Keu Yeom, Seung Young Kim, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Hong Sik Lee, Sang Woo Lee, Chang Duck Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Medical dissolution of gallstone is usually performed on radiolucent gallstones in a functioning gallbladder. However, absence of visible gallstone on plain abdominal x-ray does not always preclude calcification. This study aims to compare the response and dissolution rates between ursodeoxycholic acid (UDCA) alone or in combination with chenodeoxycholic acid (CDCA) according to stone density on computed tomography (CT) scan. A total of 126 patients underwent dissolution therapy with either UDCA alone or combination of CDCA and UDCA (CNU) from December 2010 to March 2014 at Korea University Ansan Hospital. In the end, 81 patients (CNU group=44, UDCA group=37) completed dissolution therapy for 6 months. Dissolution rate (percentage reduction in the gallstone volume) and response to therapy (complete dissolution or partial dissolution defined as reduction in stone volume of >50%) were compared between the 2 groups. Dissolution and response rates of sludge was also compared between the 2 groups. The overall response rate was 50.6% (CNU group 43.2% vs UDCA group 59.5%, P =0.14), and the overall dissolution rate was 48.34% (CNU group 41.5% vs UDCA group 56.5%, P=0.13). When analyzed according to stone density, response rate was 33.3%, 87.1%, 30.0%, and 6.2% for hypodense, isodense, hyperdense, and calcified stones, respectively. Response rate (85.7% vs 88.2%, P=0.83) and dissolution rate (81.01% vs 85.38%, P= 0.17) of isodense stones were similar between CNU and UDCA group. When only sludge was considered, the overall response rate was 87.5% (CNU group 71.4% vs UDCA group 94.1%, P = 0.19), and the overall dissolution rate was 85.42% (CNU group 67.9% vs UDCA group 92.7%, P=0.23). Patients with isodense gallstones and sludge showed much better response to dissolution therapy with CNU and UDCA showing comparable efficacy. Therefore, CT scan should be performed before medication therapy if stone dissolution is intended.

Original languageEnglish
Article number2037
JournalMedicine (United States)
Volume94
Issue number50
DOIs
Publication statusPublished - 2015

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Comparison on response and dissolution rates between ursodeoxycholic acid alone or in combination with chenodeoxycholic acid for gallstone dissolution according to stone density on CT scan: Strobe compliant observation study'. Together they form a unique fingerprint.

  • Cite this