TY - JOUR
T1 - Chemical and morphologic characteristics of cholesterol gallstones that failed to dissolve on chenodiol. The National Cooperative Gallstone Study
AU - Freilich, Howard S.
AU - Malet, Peter F.
AU - Schwartz, J. Sanford
AU - Soloway, Roger D.
PY - 1986/9
Y1 - 1986/9
N2 - During the National Cooperative Gallstone Study, chenodiol (chenodeoxycholate), 750 or 375 mg/day, resulted in complete gallstone dissolution in only 13.5% and 5.2% of patients, respectively. The purpose of this study was to analyze the composition and morphology of gallstones from patients who underwent cholecystectomy during the National Cooperative Gallstone Study to determine if calcium salts on the gallstone surface could have been responsible for failure of dissolution. Total gallstone calcium content was not different between the treated and placebo groups; however, surface calcium levels were different, being >1.0% in 47.6% of stones from chenodiol-treated patients (n = 63) but in only 16.7% of those from placebo-treated patients (n = 18), p < 0.02. Pigmented outer rims were found in 52.4% of the stones from the chenodiol-treated group compared with only 16.7% of stones from the placebo group, p < 0.01. The rim calcium content of 36 stones with pigmented outer rims was 3.7% ± 1.0%, whereas that of 45 stones with nonpigmented outer rims was only 1.0% ± 0.3%, p < 0.01. We conclude that the presence of rings of increased concentrations of calcium salts on the gallstone surface may impair dissolution by chenodiol.
AB - During the National Cooperative Gallstone Study, chenodiol (chenodeoxycholate), 750 or 375 mg/day, resulted in complete gallstone dissolution in only 13.5% and 5.2% of patients, respectively. The purpose of this study was to analyze the composition and morphology of gallstones from patients who underwent cholecystectomy during the National Cooperative Gallstone Study to determine if calcium salts on the gallstone surface could have been responsible for failure of dissolution. Total gallstone calcium content was not different between the treated and placebo groups; however, surface calcium levels were different, being >1.0% in 47.6% of stones from chenodiol-treated patients (n = 63) but in only 16.7% of those from placebo-treated patients (n = 18), p < 0.02. Pigmented outer rims were found in 52.4% of the stones from the chenodiol-treated group compared with only 16.7% of stones from the placebo group, p < 0.01. The rim calcium content of 36 stones with pigmented outer rims was 3.7% ± 1.0%, whereas that of 45 stones with nonpigmented outer rims was only 1.0% ± 0.3%, p < 0.01. We conclude that the presence of rings of increased concentrations of calcium salts on the gallstone surface may impair dissolution by chenodiol.
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U2 - 10.1016/0016-5085(86)90643-8
DO - 10.1016/0016-5085(86)90643-8
M3 - Article
C2 - 3732769
AN - SCOPUS:0022519319
VL - 91
SP - 713
EP - 718
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 3
ER -