The Effects of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Low-Dose Acetylsalicylic Acid on Radiolucent Gallstones

Abstract

Background/aims: Mucin, a high molecular weight glycoprotein secreted by the gallbladder and biliary duct epithelium, is a pronucleating agent in experimental and human gallstone disease. Blockage of mucin release with aspirin inhibits the formation of primary gallstones in animal models. The aim of this study was to compare the effects of ursodeoxycholic acid alone and plus low-dose aspirin on dissolution of solitary or multiple gallstones. Methods: There were three treatment groups comprising 43 patients with cholesterol gallstones: Group I (n=16, 13 females, three males) was givenursodeoxycholic acid (15 mg. kg. day) alone and Group II (n=14, 12 females, two males) was treated with aspirin (100 mg/day) in addition to ursodeoxycholic acid cholic. Group III was a control group of 13 cases (11 females, two males) who were monitored without medical treatment. Stone dissolution rates were evaluated sonographically in all patients at three month intervals during the treatment period. Results: After 12 months of treatment, stone dissolution was found in six (37.5%) of the patients in Group I and six (42.8%) of the patients in Group II. The difference in both treatment groups was significant compared to controls (p<0.05) but there was no significant difference between the two treatment groups (p>0.05). Of the cases in whom dissolution was achieved, all patients had multiple gallstones except for one with a solitary stone in Group I. Gallstones were not dissolved of any subject of group III. Conclusions: The results showed that ursodeoxycholic acid cholic therapy is more effective in the dissolution of multiple gallstones than of solitary ones. Combination with aspirin did not potentiate the efficacy of ursodeoxycholic acid cholic.