May 13, 1974

Cholesterol Cholelitholysis

JAMA. 1974;228(7):874-875. doi:10.1001/jama.1974.03230320044032

When, early in 1972, a Mayo Clinic group of workers reported1 their experience with chenodeoxycholic acid, they raised hopes for the elusive medical cure of cholesterol gallstones. Here was a therapy based on sound evidence that in cholesterol gallstone disease the concentration of bile acids and lecithin is insufficient to keep all of the cholesterol in micellar solution and that chenodeoxycholic acid given orally for four months corrects this deficiency.2 (A detailed discussion of the mechanism of this correction can be found in the December 1973 issue of the Archives of Surgery.3)

True, the therapeutic success was limited. In only one of the seven treated patients did the stones disappear completely, and only in three others did they decrease in size after six months of treatment. Furthermore, the study was uncontrolled. Nevertheless, the foot was in the door of the surgical operating room.

The door was opened