Light and electron microscopy of human liver before and during chenodeoxycholic acid therapy.

Thirteen patients (9 women, 4 men) with solitary (7) or multiple (6) radiolucent gallstones were treated with 1.0 g/day CDCA over a period of 7--17 months (mean 10.2). Routine liver function tests showed no changes compared to pre-treatment values, except a moderate elevation of SGPT activity in one patient. Serum cholesterol and serum triglyceride levels remained unchanged during therapy. 21 liver biopsies in 11 patients compared to pre-treatment controls studied by light and electron microscopy revealed no lesions in hepatic structure, especially no signs of cholestasis. Only some unspecific changes in liver ultrastructure as shown during therapy with other drugs developed during CDCA treatment (lipofuscin depositions, swollen and condensed mitochondria and a dilated rough endoplasmic reticulum). It is, therefore, concluded that CDCA therapy for gallstone dissolution has no hepatotoxic side effects.