Which of the following is a contraindication for Medical dissolution therapy for gallstones?
|C||Normal functioning gall bladder|
(Ref. Harrison’s principle’s of internal medicine 18th/ Pg. 1997)
Radio-opaque stones is a contraindication for Medical dissolution therapy for gallstones.
a. In carefully selected patients with a functioning gallbladder and with radiolucent stones <10 mm in diameter, complete dissolution can be achieved in ~50% of patients within 6 months to 2 years with UDCA at a dose of 8–10 mg/kg per day.
b. The highest success rate (i.e., >70%) occurs in patients with small (<5 mm) floating radiolucent gallstones.
c. Probably ≤ 10% of patients with symptomatic cholelithiasis are candidates for such treatment. However, in addition to the vexing problem of recurrent stones (30–50% over 3–5 years of follow-up), there is also the factor of taking an expensive drug for up to 2 years. The advantages and success of laparoscopic cholecystectomy have largely reduced the role of gallstone dissolution to patients who wish to avoid or are not candidates for elective cholecystectomy.