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Gallstone dissolution in the biliary tract: in vitro investigations on inhibiting factors and special dissolution agents. 1982

U Leuschner, and H Baumgärtel

Investigations of four bile duct stones demonstrated that the distribution of organic compounds, pigments, and crystalline calcium salts as well as the stone architecture can prevent dissolution with perfusion therapy. We describe perfusion media that will dissolve or disaggregate the substances mentioned in vitro. Isolated organic compounds, probably mucoproteins, could be disaggregated with a SH-activated enzyme-containing bile salt-EDTA-solution (BA-EDTA) at pH 6.5-8.2. After admixture of 5-10% glyceryl-1-monooctanoin-carnosine to the BA-EDTA solution a mucoprotein-rich pigment concrement (calcium-bilirubinate stone) was completely disaggregated and the calcium and pigment portion was dissolved within 36 h. Alternating administration of an enzyme-free BA-EDTA solution with glyceryl-1-monooctanoin-carnosine resulted in accelerated dissolution of a pigment containing cholesterol stone compared to CApmul 8210. These perfusion media have been successfully used in patients. Factors limiting stone dissolution remain stone architecture, crystalline carbonic occlusions in high concentration, and the topography of the biliary tree.

UI MeSH Term Description Entries
D010477 Perfusion Treatment process involving the injection of fluid into an organ or tissue. Perfusions
D002210 Caprylates Derivatives of caprylic acid. Included under this heading are a broad variety of acid forms, salts, esters, and amides that contain a carboxy terminated eight carbon aliphatic structure. Caprylate,Octanoates,Caprylic Acids,Octanoic Acids,Acids, Caprylic,Acids, Octanoic
D002336 Carnosine A naturally occurring dipeptide neuropeptide found in muscles. Carnosine Hydrochloride,Carnosine, (D-His)-Isomer,L-Carnosine,beta-Alanylhistidine,Hydrochloride, Carnosine,L Carnosine,beta Alanylhistidine
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D004151 Dipeptides Peptides composed of two amino acid units. Dipeptide
D004492 Edetic Acid A chelating agent that sequesters a variety of polyvalent cations such as CALCIUM. It is used in pharmaceutical manufacturing and as a food additive. EDTA,Edathamil,Edetates,Ethylenediaminetetraacetic Acid,Tetracemate,Calcium Disodium Edetate,Calcium Disodium Versenate,Calcium Tetacine,Chelaton 3,Chromium EDTA,Copper EDTA,Coprin,Dicobalt EDTA,Disodium Calcitetracemate,Disodium EDTA,Disodium Ethylene Dinitrilotetraacetate,Distannous EDTA,Edetate Disodium Calcium,Edetic Acid, Calcium Salt,Edetic Acid, Calcium, Sodium Salt,Edetic Acid, Chromium Salt,Edetic Acid, Dipotassium Salt,Edetic Acid, Disodium Salt,Edetic Acid, Disodium Salt, Dihydrate,Edetic Acid, Disodium, Magnesium Salt,Edetic Acid, Disodium, Monopotassium Salt,Edetic Acid, Magnesium Salt,Edetic Acid, Monopotassium Salt,Edetic Acid, Monosodium Salt,Edetic Acid, Potassium Salt,Edetic Acid, Sodium Salt,Ethylene Dinitrilotetraacetate,Ethylenedinitrilotetraacetic Acid,Gallium EDTA,Magnesium Disodium EDTA,N,N'-1,2-Ethanediylbis(N-(carboxymethyl)glycine),Potassium EDTA,Stannous EDTA,Versenate,Versene,Acid, Edetic,Acid, Ethylenediaminetetraacetic,Acid, Ethylenedinitrilotetraacetic,Calcitetracemate, Disodium,Dinitrilotetraacetate, Disodium Ethylene,Dinitrilotetraacetate, Ethylene,Disodium Versenate, Calcium,EDTA, Chromium,EDTA, Copper,EDTA, Dicobalt,EDTA, Disodium,EDTA, Distannous,EDTA, Gallium,EDTA, Magnesium Disodium,EDTA, Potassium,EDTA, Stannous,Edetate, Calcium Disodium,Ethylene Dinitrilotetraacetate, Disodium,Tetacine, Calcium,Versenate, Calcium Disodium
D005989 Glycerides GLYCEROL esterified with FATTY ACIDS. Acylglycerol,Acylglycerols
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001647 Bile Acids and Salts Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. Bile Acid,Bile Salt,Bile Salts,Bile Acids,Acid, Bile,Acids, Bile,Salt, Bile,Salts, Bile
D012995 Solubility The ability of a substance to be dissolved, i.e. to form a solution with another substance. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Solubilities

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