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More on Chenodiol: Continued Treatment and Prevention of Recurrences

ROBERT H. PALMER, M.D.
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Columbia University College of Physicians and Surgeons; New York, New York


Ann Intern Med. 1984;100(3):450-451. doi:10.7326/0003-4819-100-3-450
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The results of the National Cooperative Gallstone Study reported in 1981 (1) were disappointing. After patients received chenodiol, 750 or 375 mg/d, or placebo for 2 years, complete dissolution of gallstones occurred in 13.5%, 5.2%, and 0.8%, respectively; partial dissolution (> 50%) occurred in 27.3%, 18.4%, and 10.2%. Two reasons for the poor response have been proposed (2): First, because the dose was suboptimal (as we now know) and for other reasons, bile may have been inadequately desaturated. Second, characteristics of the stones themselves may have prevented dissolution. If desaturation was inadequate, a longer period of treatment (or other measures)

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