Tangedahl T
Surg Clin North Am. 1979 Oct;59(5):797-809. doi: 10.1016/s0039-6109(16)41929-8.
Availability of bile acid therapy for gallstone dissolution adds another therapeutic choice for treatment of gallstone disease. Because dissolution is slow and eventual outcome uncertain, surgery remains the treatment of choice for most patients who have experienced symptoms clearly related to their gallstones. Patients with only dyspeptic or no gastrointestinal symptoms, especially if significant associated cardiac or pulmonary disease exists, may be candidates for bile acid therapy with chenodeoxycholic acid or its 7-beta epimer, ursodeoxycholic acid, when available. Fifty to 75 per cent of patients, depending on individual criteria, may anticipate complete dissolution. Radiolucent gallstones and gallbladder opacification are basic requirements for cholelitholytic therapy. Periodic assessment of laboratory parameters is necessary at routine visits and when unexpected symptoms occur. In a few patients, evidence of obstructive gallstone disease will develop during bile acid therapy and surgery will be required. The value of bild acid therapy for the relief of dyspeptic symptoms, the role of bile analysis, and optimal long-term therapy remain to be established.
胆汁酸疗法用于胆结石溶解为胆结石疾病的治疗增加了另一种治疗选择。由于溶解过程缓慢且最终结果不确定，对于大多数有明确与胆结石相关症状的患者，手术仍是首选治疗方法。仅有消化不良或无胃肠道症状的患者，尤其是存在严重相关心脏或肺部疾病时，如有鹅去氧胆酸或其7-β差向异构体熊去氧胆酸，可考虑进行胆汁酸治疗。根据个体标准，50%至75%的患者有望实现完全溶解。透X线胆结石和胆囊显影是溶石疗法的基本要求。在常规就诊以及出现意外症状时，定期评估实验室指标是必要的。少数患者在胆汁酸治疗期间会出现梗阻性胆结石疾病的证据，此时需要进行手术。胆汁酸疗法缓解消化不良症状的价值、胆汁分析的作用以及最佳长期治疗方案仍有待确定。
