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PubMed · 6503981

[Gallstone solubilizers].

H Ighimi
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Abstract

In spite of the great progress seen in the diagnostic and treating method for gallstone patients in this 10 years, the criteria of the operative indication for these patients have not been discussed for a long time. I wish to emphasize it is high time for us to examine a matter, since chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) have begun to be popular in Japanese medical field as an oral gallstone solubilizer. I have mentioned the different dissolving mechanism of cholesterol after the administration of CDCA or UDCA. Recently, residual gallstones are removed using the newly developed instruments, such as a duodenal fiberscope, a choledochal fiberscope, a specially designed basket catheter and a YAG laser knife. Direct gallstone solubilizer, however, is still useful for special cases where gallstones are difficult to be removed by mechanical means. In an attempt to give answer to this, we have developed and used clinically the mixed solution of d-limonene and middle chain monoglyceride for cholesterol gallstones and 90% dimethyl sulfoxide and chelating polyphosphate for bilirubin gallstones.

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Chenodeoxycholic AcidCholelithiasisCyclohexenesDeoxycholic AcidDimethyl SulfoxideHumansLimoneneSolubilityTerpenesUrsodeoxycholic AcidJournal Article

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H Ighimi. 1984. [Gallstone solubilizers].. https://pubmed.ncbi.nlm.nih.gov/6503981/

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PubMed2003

Mutations in SRD5B1 (AKR1D1), the gene encoding delta(4)-3-oxosteroid 5beta-reductase, in hepatitis and liver failure in infancy.

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PubMed2002

The UDCA dosage deficit: a fate shared with CDCA.

Ursodeoxycholic acid (UDCA) is used both as the treatment of choice in many cholestatic syndromes and as complementary therapy in many liver diseases. However, few dose-finding studies exist, and none has evaluated the efficacy and long-term safety of UDCA therapy in primary biliary cirrhosis (PBC). There is an open debate about UDCA's impact on the natural history of PBC, and no universal evidence of benefits on the major endpoint exists. This is perhaps due to a UDCA dosage deficit. Most clinical trials on PBC therapy have used conservative dosages of UDCA similar to those of chenodeoxycholic acid (CDCA) used for dissolution of gallstones. It may be necessary to re-evaluate the dosage of UDCA that provides the most effective treatment.

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