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Combined bile acid therapy is more effective on biliary lipids and dissolution rates than monotherapy after gallstone lithotripsy.
Am J Gastroenterol 1995; 90(11):1942-8AJ

Abstract

BACKGROUND

Accurate sampling of gallbladder bile for biliary analysis is essential for determining any potential difference between combined bile acid therapy and monotherapy in gallstone patients.

METHODS

In 104 gallstone patients undergoing extracorporeal shock wave lithotripsy with following bile acid therapy [either chenodeoxycholic acid (500 mg/day) and ursodeoxycholic acid (500 mg/day), group I (n = 53), or ursodeoxycholic acid alone (1000 mg/day), group II (n = 51)], bile samples, obtained by direct fine needle puncture of the gallbladder, were investigated for biliary lipids, total biliary protein concentration, and nucleation time before and after 12 months of bile acid therapy.

RESULTS

Initially, a negative correlation was found between nucleation time and number of gallstones and between total biliary protein concentration and nucleation time (r = -0.52 and r = -0.49 in group I vs r = -0.56 and r = -0.51 in group II, p < 0.01 in each group). The correlation between total biliary protein concentration and nucleation time was also found after 12 months of bile acid treatment (r = -0.54 in group I vs r = -0.47 in group II, p < 0.01 in each group). In group I, the decrease in cholesterol saturation index, biliary cholesterol, cholic acid, deoxycholic acid, and total protein concentration was more pronounced than in group II (p < 0.01). The same effect was found concerning the prolongation of nucleation time (p < 0.01). Furthermore, dissolution rates were higher in group I compared with group II (80.4 vs 69.0%, p < 0.01).

CONCLUSION

In gallstone patients, combined therapy with urso- and chenodeoxycholic acid is superior to either ursodeoxycholic acid alone or biliary parameters in bile samples obtained by direct fine needle puncture of the gallbladder.

Authors+Show Affiliations

Department of Internal Medicine, Krankenhaus der Barmherzigen Brüder, Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

7484996

Citation

Tudyka, J, et al. "Combined Bile Acid Therapy Is More Effective On Biliary Lipids and Dissolution Rates Than Monotherapy After Gallstone Lithotripsy." The American Journal of Gastroenterology, vol. 90, no. 11, 1995, pp. 1942-8.
Tudyka J, Kratzer W, Janowitz P, et al. Combined bile acid therapy is more effective on biliary lipids and dissolution rates than monotherapy after gallstone lithotripsy. Am J Gastroenterol. 1995;90(11):1942-8.
Tudyka, J., Kratzer, W., Janowitz, P., Mason, R., & Wechsler, J. G. (1995). Combined bile acid therapy is more effective on biliary lipids and dissolution rates than monotherapy after gallstone lithotripsy. The American Journal of Gastroenterology, 90(11), pp. 1942-8.
Tudyka J, et al. Combined Bile Acid Therapy Is More Effective On Biliary Lipids and Dissolution Rates Than Monotherapy After Gallstone Lithotripsy. Am J Gastroenterol. 1995;90(11):1942-8. PubMed PMID: 7484996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined bile acid therapy is more effective on biliary lipids and dissolution rates than monotherapy after gallstone lithotripsy. AU - Tudyka,J, AU - Kratzer,W, AU - Janowitz,P, AU - Mason,R, AU - Wechsler,J G, PY - 1995/11/1/pubmed PY - 1995/11/1/medline PY - 1995/11/1/entrez SP - 1942 EP - 8 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 90 IS - 11 N2 - BACKGROUND: Accurate sampling of gallbladder bile for biliary analysis is essential for determining any potential difference between combined bile acid therapy and monotherapy in gallstone patients. METHODS: In 104 gallstone patients undergoing extracorporeal shock wave lithotripsy with following bile acid therapy [either chenodeoxycholic acid (500 mg/day) and ursodeoxycholic acid (500 mg/day), group I (n = 53), or ursodeoxycholic acid alone (1000 mg/day), group II (n = 51)], bile samples, obtained by direct fine needle puncture of the gallbladder, were investigated for biliary lipids, total biliary protein concentration, and nucleation time before and after 12 months of bile acid therapy. RESULTS: Initially, a negative correlation was found between nucleation time and number of gallstones and between total biliary protein concentration and nucleation time (r = -0.52 and r = -0.49 in group I vs r = -0.56 and r = -0.51 in group II, p < 0.01 in each group). The correlation between total biliary protein concentration and nucleation time was also found after 12 months of bile acid treatment (r = -0.54 in group I vs r = -0.47 in group II, p < 0.01 in each group). In group I, the decrease in cholesterol saturation index, biliary cholesterol, cholic acid, deoxycholic acid, and total protein concentration was more pronounced than in group II (p < 0.01). The same effect was found concerning the prolongation of nucleation time (p < 0.01). Furthermore, dissolution rates were higher in group I compared with group II (80.4 vs 69.0%, p < 0.01). CONCLUSION: In gallstone patients, combined therapy with urso- and chenodeoxycholic acid is superior to either ursodeoxycholic acid alone or biliary parameters in bile samples obtained by direct fine needle puncture of the gallbladder. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/7484996/Combined_bile_acid_therapy_is_more_effective_on_biliary_lipids_and_dissolution_rates_than_monotherapy_after_gallstone_lithotripsy_ L2 - https://medlineplus.gov/gallstones.html DB - PRIME DP - Unbound Medicine ER -