Efficacy of Chenodeoxycholic Acid and Ursodeoxycholic Acid for Lowering Cholesterol Saturation Index of Gallbladder in Patients With a Sphincterotomy

Peter B. Meier, Howard J Ansel, Rex B. Shafer, William C Duane

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

After endoscopic retrograde sphincterotomy, patients with an intact gallbladder are at risk for developing symptoms or complications of gallbladder stones. Medical dissolution of such stones would be desirable, especially in elderly patients with an increased surgical risk. However, sphincterotomy alters emptying dynamics of the gallbladder and markedly reduces bile salt pool size, effects that may alter response to chenodeoxycholic acid or ursodeoxycholic acid treatment. Studying two groups of 5 patients with an intact gallbladder after endoscopic retrograde sphincterotomy, we found that 15 mg/kg · day of chenodeoxycholic acid increased the mean (±SEM) biliary percentage of chenodeoxycholic acid from 35.5% ± 4.0% to 88.8% ± 1.9% (p < 0.01) and decreased the mean saturation index of gallbladder bile from 1.02 ± 0.22 to 0.55 ± 0.08 (p < 0.05). Ursodeoxycholic acid (10 mg/kg · day) increased the mean biliary percentage of ursodeoxycholic acid from 5.6% ± 1.5% to 44.7% ± 5.8% (p < 0.01) and decreased the mean saturation index of gallbladder bile from 1.04 ± 0.25 to 0.57 ± 0.03 (p < 0.05). A long-term trial of bile acid treatment in sphincterotomy patients with stones in an intact gallbladder is needed.

Original languageEnglish (US)
Pages (from-to)1595-1600
Number of pages6
JournalGastroenterology
Volume95
Issue number6
DOIs
StatePublished - Jan 1 1988

Keywords

  • endoscopic retrograde sphincterotomy
  • ERS

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