Jüngst, Dieter and Brenner, Gerhard and Pratschke, Ekkehard and Paumgartner, Gustav
Low-dose ursodeoxycholic acid prolongs cholesterol nucleation time in gallbladder bile of patients with cholesterol gallstones.
In: Journal of Hepatology, Vol. 8, No. 1: pp. 1-6
The high rate of stone recurrence represents a drawback of non-surgical therapy of cholesterol gallstone disease. Although most studies report that long-term bile acid treatment does not have protective effects, preliminary results suggest that low-dose ursodeoxycholic acid decreases the rate of gallstone recurrence in a subgroup of younger patients. To clarify the underlying mechanism we investigated whether low-dose ursodeoxycholic acid treatment influences biliary cholesterol saturation and/or nucleation time of cholesterol. Ten patients with cholesterol gallstones and functioning gallbladder received 250 mg ursodeoxycholic acid/day at bedtime 6–10 days prior to cholecystectomy. Eleven patients with cholesterol gallstones without treatment served as controls. Cholesterol crystals were present in the gallbladder bile of 7 out of the 10 patients receiving ursodeoxycholic acid and in all control biles. Ursodeoxycholic acid treatment significantly (P < 0.02) decreased the cholesterol saturation index (mean ± S.E.: 0.94 ± 0.05 vs. 1.43 ± 0.18) and led to an approximately 5-fold prolongation (P < 0.005) of the cholesterol nucleation time (mean ± S.E.: 12.0 ± 2,4 vs. 2.3 ± 0.7 days). We conclude that lowdose ursodeoxycholic acid might be effective in the prevention of post-dissolution gallstone recurrence by both decreasing cholesterol saturation and prolonging cholesterol nucieation time