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Medicine Misc. b1b71637

Medical treatment of gallstone indicated in A/E:

A
GB should be functioning
B
Gallstone should be radiolucent
C
Gallstone should be radio opaque
D
Patient is unfit for surgery
High-Yield Explanation
For good results, medical therapy should be limited to radiolucent stones smaller than 5 mm in diameter. Stones larger than 15 mm in size rarely dissolve. Pigment stones are not responsive to UDCA therapy to produce a lamellar liquid crystalline phase in bile that allows a dispersion of cholesterol from stones. Ursodeoxycholic acid decreases cholesterol saturation of bile. UDCA may also retard cholesterol crystal nucleation.

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