Litholytic agents: An alternative therapy to treat biliary dyspepsia

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Created On: 02/12/2020

Litholytic agents: An alternative therapy to treat biliary dyspepsia

A retrospective study aimed to explore the effects of treatment with litholytic agents (ursodeoxycholic acid [UDCA] and a combination of chenodeoxycholic acid and ursodeoxycholic acid [CNU]) in patients suffering from biliary dyspepsia.

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Key take away

In patients having biliary dyspepsia, litholytic agents were found to remarkably improve the symptoms of biliary colic.

Background

Method

The electronic medical records of 414 patients suffering from biliary pain and who underwent cholescintigraphy from July 2008 to August 2018 were retrospectively reviewed. Participants who were given litholytics and underwent follow-up scans following medical therapy were recruited in this study.

Participants were assigned either to the GD arm (biliary dyspepsia with declined gallbladder ejection fraction [GBEF]) or the NGD arm (biliary dyspepsia with normal GBEF). Comparison of the pre- and post-treatment GBEF and symptoms were done. Improvement in GBEF and symptoms were the study endpoints.

Result

Among 57 subjects enrolled, about 40 (70.2%) participants were found to have vital GBEF improvement after the treatment, ranging from 34.4 ± 22.6% to 53.8 ± 26.8%. In the GD group, the value of GBEF considerably improved from 19.5 ± 11.0 to 47.9 ± 27.3%. However, in the NGD group, the value of GBEF did not considerably change.

In both groups, most patients witnessed improvement in their symptoms after medical therapy. No severe complication was witnessed during the treatment period. The number of patients having GBEF improvement and percentage of patients having improved symptoms after medical treatment is depicted in the table below:

Litholytics represent a substitute for surgical therapy for biliary dyspepsia with or without gallbladder dyskinesia, specifically in individuals for whom surgery is not advocated. The biliary colic in patients having gallbladder dyskinesia improved after GBEF normalization.

Furthermore, in patients having biliary dyspepsia with reduced GBEF, treatment with litholytics remarkably regulated the GBEF and elicited symptom improvement. Medical therapy displayed a low complication rate.

Conclusion

Litholytics are an alternative therapeutic modality for biliary dyspepsia patients with or without gallbladder dyskinesia as it significantly minimizes biliary pain and improves symptoms.