Læknablaðið : fylgirit - 01.08.1978, Page 18

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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).