Surgery Book

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Bile Acid Oral Dissolution TherapyAka: Ursodeoxycholic Acid, Ursodiol, Actigal, Oral Dissolution Therapy

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  1. Indication: Cholelithiasis
    1. Comorbid condition that precludes safe Cholecystectomy
    2. Symptomatic patient unwilling to undergo surgery
  2. Inclusion Criteria required (only 15% of patients)
    1. Small, floating, Cholesterol Gallstones (<0.5mm)
    2. Functional Gallbladder
  3. Treatment Protocol: Ursodiol (Actigal)
    1. Dose: 8-10 mg/kg/day PO divided bid to tid
    2. Course: 6-12 months
  4. Efficacy
    1. Stones dissolving over 6-12 months: 60-90%
    2. Stones reoccuring within 5 years: 25-50%
    3. Better prognosis associated factors
      1. Single Gallstone and
      2. non-obese and
      3. Young patient

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