Pilot study of combination treatment for gall stones with medium dose chenodeoxycholic acid and a terpene preparation.

Abstract

Thirty patients with radiolucent stones in a radiologically functioning gall bladder were treated for up to two years with a combination of Rowachol (one capsule twice daily), a mixture of cyclic monoterpenes, and chenodeoxycholic acid (7-0-10-5 mg/kg/day). The patients were not selected for body weight or size of stones. All complete dissolutions diagnosed by oral cholecystography were confirmed or refuted by ultrasound examination. Control of symptoms was excellent, only one patient withdrawing from the study because of persistent biliary pain. No evidence of hepatotoxicity was detected biochemically, and diarrhoea due to chenodeoxycholic acid was minimal at this dose. Stones disappeared completely in 11 patients (37%) within one year and in 15 (50%) within two years.These results compared favourably with those obtained with similar doses of chenodeoxycholic acid alone, in particular those of the National Co-operative Gallstone

Is the addition of choleretic agents in multiple double-pigtail biliary stents effective for difficult common bile duct stones in elderly patients? A prospective, multicenter study

“…17,24,25 Previous reports for terpene were targeted for gallstones. 17,18,24,25 Galandi et al 26 stated that UDCA, terpene, and/or antibiotics to prevent clogging of biliary stents in patients with malignant biliary strictures cannot be recommended in systematic review. The effect on CBD stones has not been established.…”

“…UDCA is a hydrophilic dihydroxy bile acid that can dissolve gallstones, and a terpene preparation has been shown to enhance the solubility of cholesterol, calcium carbonate, and calcium phosphate, making it a potent choleretic agent. [16][17][18] Our study was designed to investigate the effectiveness of multiple biliary stenting with or without UDCA and a terpene preparation for the treatment of difficult CBD stones in elderly patients with a high risk of surgical complications or who refused an operation because of comorbid cardiopulmonary and/or cerebrovascular diseases.…”

Mentholsubstitution als Option zur Dosisreduktion von Urso- und Chenodeoxycholsäure in der adjuvanten Therapie nach ESWL von Gallenblasensteinen

“…1979 dokumentierten auch Bell & Doran in mehreren Untersuchungen die Auflösung von Gallenblasensteinen durch das Terpenpräparat Rowachol ® allein oder in Kombination mit der Gallensäure Ursodeoxycholsäu-re [2]. Ellis et al bestätigten diese Ergebnisse mit der Gallensäure Chenodeoxycholsäure [3]. Leuschner Die Studiendaten wurden mit dem "two one-sided t-test" ausgewertet.…”

Non-Surgical Approaches to Stones in the Biliary Tree

“…Not withstanding this fact, a combination of a bile acid and Rowachol probably offers the best results with up to 80% disappearance of com mon duct stones following 1 -2 years of therapy [40]. However, up to 2 years, medical therapy is no longer a realistic alternative to sphincte rotomy which can remove the common bile duct stones, with a 24-hour hospital stay.…”

“…It has been reported to enhance the effects of medium dose chcnodeoxycholic acid in patients with pure choles terol stones with a functioning gall bladder [40], However, its use has not been universally tested. Consequently, further work is required before one could testify to its efficacy.…”