NATURAL-HISTORY AND TREATMENT WITH URSODIOL OF GALLSTONES FORMED DURING RAPID LOSS OF WEIGHT IN MAN

Cholesterol gallstones form frequently among obese patients during rap id loss of weight. The aims of the present study were to determine the short-term natural history of these gallstones and the efficacy of ur sodiol for their dissolution. Twenty-two patients whose gallstones had formed during rapid loss of weight were randomized in double-masked f ashion to either ursodiol, 1200 mg/day, or placebo for nine months. Ul trasonography of the gallbladder was performed after three and nine mo nths of treatment. All patients without disappearance of their gallsto nes after nine months received open-label ursodiol for an additional n ine months with ultrasonography after three and nine months. Among the patients completing three months of masked treatment, disappearance o f gallstones was seen in five of 11 patients who received placebo and four of seven patients who received ursodiol. Only one additional pati ent of six continuing placebo for nine months experienced disappearanc e. Neither of two patients continuing ursodiol for nine months had dis appearance of gallstones. None of the five patients treated with open- label ursodiol for nine months had disappearance of gallstones. Thus, half of the gallstones that form during rapid loss of weight disappear rapidly once loss of weight ceases; ursodiol may not increase the fre quency or rapidity of their disappearance.