Medical treatment of gallstone indicated in A/E:
GB should be functioning
Gallstone should be radiolucent
Gallstone should be radio opaque
Patient is unfit for surgery
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.
Misc.