Læknablaðið : fylgirit - 01.08.1978, Side 18

Læknablaðið : fylgirit - 01.08.1978, Side 18
16 use of both these substances in the medical treatment of gallstones. SELECTION OF THE MOST APPROPRIATE MANAGEMENT AFTER GALLSTONE DISSOLUTION It now seems that the metabolic ab- normality which leads to supersaturated bile is only temporarily suppressed during chenotherapy. When treatment is stopped following successful gallstone dissolution, bile reverts to its supersaturated state and gallstones recur in up to 50% of patients. If high and early recurrence rates are con- firmed, it seems likely that we will have to choose between diet, low-dose, inter- mittent-dose or full maintenance-doses of CDCA to prevent gallstones from re- forming. At present, we have no informa- tion about which of these approaches should be selected. Indeed, the whole future of gallstone dissolution therapy with CDCA or UDCA is ultimately likely to hinge round the question of gallstone recurrence and the practicality of treating patients for life. ACKNOWLEDGEMENTS I am grateful to my colleagues Duncan Bell, Henry Mok, John Iser, Paul Maton, Adrian Reuben and Gerry Murphy on whose work the conclusions in this review are based. Thanks are also due to Messrs Weddel Pharmaceuticals who gave us supplies of CDCA (,,Chendol“) and who supported our research and to Miss Caro- line Greer who kindly typed the manu- script. Fyrsta læknaráð á íslenzku sjúkrahúsi (1967—68): Halldór Steinsen, Bergsveinn Ólafs- son, Tómas Á. Jónasson, Bjarni Jónsson, Páll Sigurðsson, Guðjón Lárusson, Kjartan Magnússon. (Myndin tekin í desember 1977).

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