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Low-Dose Chenodiol to Prevent Gallstone Recurrence After Dissolution Therapy

JAY W. MARKS, M.D.; SHU-PING LAN; RICHARD A. BAUM, M.D.; ROBERT L. HABIG, Ph.D.; RUSSELL F. HANSON, M.D.; THEODORE HERSH, M.D.; N.C. HIGHTOWER Jr, M.D.; ALAN F. HOFMANN, M.D.; JOHN M. LACHIN, Sc.D.; ELLIOTT C. LASSER, M.D.; HAGOP MEKHJIAN, M.D.; RONALD OKUN, M.D.; ROBERT A. SCHAEFER, M.D.; LESLIE J. SCHOENFIELD, M.D.; ROGER D. SOLOWAY, M.D.; JOHNSON L. THISTLE, M.D.; FRED B. THOMAS, M.D.; and MALCOLM P. TYOR, M.D.
[+] Article and Author Information

Presented in part in May 1983 at the annual meeting of the American Gastroenterological Association, Washington, D.C.

The contents of this publication do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial producers, or organizations imply endorsement by the U.S. Government.

▸Requests for reprints should be addressed to Jay W. Marks, M.D.; Associate Director, Division of Gastroenterology, Cedars-Sinai Medical Center, P.O. Box 48750; Los Angeles, CA 90048.


THE NATIONAL COOPERATIVE GALLSTONE STUDY GROUP; Los Angeles, California; and Bethesda, Maryland


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;100(3):376-381. doi:10.7326/0003-4819-100-3-376
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Chenodiol is a safe and effective agent for the medical dissolution of gallstones in selected patients; however, after dissolution and cessation of treatment, gallstones recur. This study was done to determine the recurrence rate after successful medical treatment and cessation of chenodiol therapy; compare the efficacy and safety of low-dose chenodiol, as compared to placebo, for prophylaxis against recurrence; and identify factors predictive of recurrence. In a randomized, double-blind fashion, 53 patients with gallstone dissolution received either chenodiol, 375 mg/d, or placebo, for at least 2 years. Standardized oral cholecystograms were done at 6 months, 1 year, and then yearly thereafter. Routine laboratory testing was done every 6 months. The cumulative rate of recurrence (life-table) was 27% in patients followed for up to 3.5 years. Chenodiol, 375 mg/d, was ineffective in preventing the recurrence of gallstones. No demographic, clinical, roentgenographic, or biochemical characteristics were predictive of recurrence.

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